A rather wide clinical experience in the treatment of metastatic renal cell cancer with rIL-2 based regimens has been accumulated over the last ten years. It appears that overall clinical responses are observed in 25% of the patients but less than 30% of the responses reach one year in duration. The target is only partially hit. To achieve more tangible clinical results we should concentrate on several aspects. First, a more accurate selection of patients that could be based on the assessment of biological parameters associated with positive clinical outcome (i.e. total lymphocyte counts, NK/LAK activity, eosinophil levels), and on the detection of substances known to exert a depressive effect on rIL-2 activity (i.e. TGF-B, PGE-2, neopterin, IL-10) at baseline and their evolution during treatment. Second, it is apparent that the standard schedules of administration of immunotherapy are suboptimal to trigger the threshold of the immune response in the averge cancer patient. Our background experiences now are sufficient to justify the exploration of different schedules and dosages. Third, the association of immunotherapy with cytotoxic drugs is worth studying although the ideal compound, dosage and schedule are still to be defined. Finally, it is crucial to investigate supplementary forms of treatment like, for example, the transduction of tumor cells with genes to obtain an elevated production of cytokines at tumor sites.
|Number of pages||4|
|Journal||Acta Urologica Italica|
|Publication status||Published - 1996|
- renal cell cancer
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