Immunotherapy of Metastatic Renal Cell Cancer

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Abstract
The management of metastatic renal cancer remains a therapeutic challenge. Conventional cytotoxic chemotherapy is rarely effective, and the most promising approaches appear to lie in the field of immunotherapy. The authors review the literature regarding current and investigational immunotherapy approaches to the management of metastatic renal cancer. The mechanism of action, methods of delivery, efficacy, and side effect profile of the cytokines IL-2 and interferon alfa are discussed. The role of investigational approaches such as tumor vaccines, antibody-based therapy, lymphocyte infusions, and bone marrow transplantation is addressed. The rationale for nephrectomy as an adjunctive procedure to immunotherapy is also discussed. Ongoing laboratory investigation of the cause of the immune deficit in patients with metastatic renal cell cancer will result in the development of novel therapies to enhance tumor cell recognition as well as host antitumor response. Translation of laboratory findings into the clinic will be facilitated by the presence of an already well-developed infrastructure for the performance of clinical trials for patients with this difficult diagnosis.