Re: Ten-year survival analysis for renal carcinoma patients treated with an autologous tumour lysate vaccine in an adjuvant setting

摘要

Expert's summary: Despite evidence for significantly improved survival by autologous tumour cell vaccination therapy, the procedure has not become standard. Between August 1993 and December 1996, 1267 renal cell carcinoma (RCC) patients undergoing radical nephrectomy in 84 German hospitals were subsequently treated by autologous tumour cell vaccination. The study group comprised 692 patients with complete follow-up (stages pT2-T3, pNx-2, MO). Subsequent propensity score matching according to seven defined criteria with 861 control patients undergoing nephrectomy alone resulted in 495 matched pairs. Overall survival (OS) rates and stage-specific survival rates were analysed after a median follow-up of 131 mo. The 5- and 10-yr OS rates were 80.6% and 68.9% in the vaccine group and 79.2% and 62.1% in the control group (p = 0.066). Patients with stage pT3 RCC revealed 5- and 10-yr OS rates of 71.3% and 53.6% in the study group and 65.4% and 36.2% in the control group (p = 0.022). In multivar-iable analysis, patients in the vaccine group showed significantly improved survival both in the whole study group (hazard ratio [HR]: 1.28, p = 0.030) and in the subgroup presenting with stage pT3 tumours (HR: 1.67, p = 0.011). Adjuvant treatment with autologous vaccination therapy resulted in significantly improved OS in stage pT3 RCC patients.