摘要:

AbstractIn order to define the prognostic factors for metastatic renal carcinoma, we reviewed 134 patients who were treated from 1971 through 1986. Survival rates were 72,45, and 25% at 6, 12, and 18 months, respectively. Seventeen variables were tested using the logrank test. Improved survival was correlated with normal performance status, and an absence of fever, weight loss, hepatic metastasis, and lung metastasis (or, if lung metastasis was present,<2 cm in diameter and limited to one site), a disease‐free interval, sedimentation rate<100, and renal surgery. Four variables retained significant value in the multivariate analysis: hepatic metastasis, lung metastasis, disease‐free interval, and a variable combining the sedimentation rate and the weight loss (SWRL). Predictive survival rates based on these variables were calculated from the Cox model. Six subgroups of patients were identified. The estimation of survival is clinically of value for future phase II trials of chemotherapy in patients with adult metastatic renal carcin

ISSN:8756-0437    

DOI:10.1002/ssu.2980040302

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractMonoclonal antibody technology permits the preparation of tumor‐specific immunoglobulin reagents that can be used directly in tumor therapy or that can be coupled to various chemotherapeutic drugs or toxins to aid in their delivery to the tumor site and thus enhance their therapeutic effectiveness. Additionally, recombinant DNA technology has facilitated the economic production of rare lymphokines (e.g., interleukin 2, interferon and interferon γ) or cytokines (tumor necrosis factor, lymphotoxin) that can either modulate the host immune response or kill tumor cells, respectively. These developments collectively have led to the development of a fourth modality for treatment of human cancers—biotherapy—as an addition to surgery, radiation, and chemotherapy modalities. This paper presents the rationale and emerging practice of the biotherapy of cancer and documents early clinical results, including the treatment of metastatic renal carcinoma at the Biological Therapy Ins

ISSN:8756-0437    

DOI:10.1002/ssu.2980040303

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractThe current literature concerning hormone receptors in renal cell cancer is reviewed. Our own results of histochemical determination of estrogen receptors by means of monoclonal antibodies are presented. Based on the studies that have been reviewed and the differing results of the receptor assays, we conclude that there is a very limited basis to apply hormone therapy in renal cell cancer. However, the new immunohisto‐chemical methods should be used to resolve the question about the hormone dependency of renal carcinom

ISSN:8756-0437    

DOI:10.1002/ssu.2980040304

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractTumor DNA content was analysed in 26 patients with metastatic renal cell carcinoma. The primary tumors were homogenously diploid in ten patients (38%). In 16 patients (62%) an aneuploid DNA content was found in at least one of eight tumor samples analyzed. Patients with diploid tumors survived significantly longer (P<0.001) than patients with aneuploid primary tumors (median 32.5 and 6 months, respectively). The DNA content of the metastases seems to give additional prognostic information. The results indicate that DNA content is a useful prognostic predictor in renal cell carcinoma. Patients with homogenously diploid tumors might be treated aggressively with nephrectomy and excision of apparent metastases, particularly solitary, since these patients seem to have a chance for prolonged survival time. Aneuploidy in metastases, solitary and multiple, indicates that nephrectomy is not meaningful.

ISSN:8756-0437    

DOI:10.1002/ssu.2980040305

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractVarious reports in the literature suggested active specific immunotherapy to be highly efficient in metastatic renal cell cancer (RCC). Thirty five patients with tumor stage III or IV, according to Robson, were treated with autologous or homologous cell vaccine after radical nephrectomy had been performed. In stage III tumors immunotherapy was administered as prophylaxis or after an interval, when metastases occurred. Clinical results during a 3‐year follow‐up period revealed no statistically significant differences in comparison to an age‐matched control group. There was no advantage in employing autologous instead of homologous therapy. Three‐year survival rate in stage IV tumors with autologous vaccination was 11% vs. 6% in tumors with homologous therapy. Two complete and two partial tumor remissions o

ISSN:8756-0437    

DOI:10.1002/ssu.2980040306

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractWe have used multiple interferon protocols to treat 274 patients who had metastatic renal cell carcinoma. Leukocyte (alpha) interferon in 50 patients produced 3 complete responses (CR) and 10 partial responses (PR), a 26% response rate that was nearly matched among the next 89 patients treated with recombinant alpha interferon (2 CR, 17 PR, 21%). Other types and combinations of interferon, even when coupled with cytotoxic chemotherapy or other biologic agents, did not produce better results. Interferon has definite activity against renal cell carcinoma, but clinical experience has not yet defined the optimal type dose, and treatment schedule.

ISSN:8756-0437    

DOI:10.1002/ssu.2980040307

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractFifty‐seven of 66 patients with metastatic renal cell carcinoma (RCC) were evaluable for response after treatment with Interferon (IFN) — Alfa 2a (Roferon A, Roche) with or without Vinblastine (VB). Three different dose schedules were used in 3 subsequent trials: protocol 1: (18 evaluable patients): IFN 36 × 106U tiw ± VB 0.1‐0.15 mg/kg/2–3 week; protocol 2: (13 patients): IFN 18 × 106U tiw ± VB 0.1 mg/kg/3 week; protocol 3: (26 patients): IFN 18 × 106U tiw ± VB 0.1 mg/kg/3 week. Twelve of the 57 patients obtained an objective response (CR:1; PR: 11). Regarding the main indicator lesions responses were seen in lung metastases (10), lymph node metastases (1), and bone metastases (1). The median response duration was 243 days. No significant impact of the IFN/VB treatment on survival could be demonstrated. Flulike symptoms represented the main toxicity. Four patients developed mental confusion, and in 2 patients with visual disturbances retinal exudation was observed. In more than half of the patients, the drug(s) had to be reduced, delayed, or finally discontinued due to toxicity. It is concluded that IFN with or without VB yields a 15–20% response rate in metastatic RCC. Due to the considerable toxicity of the treatment and the lack of proof of survival improvement, the clinical usefulness of IFN therapy in RCC remains questionable. However, on the background of the present therapeutic nihilism in metastatic RCC, additional clinical trials using IFN in RC

ISSN:8756-0437    

DOI:10.1002/ssu.2980040308

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractTwenty‐six patients with metastatic renal cell carcinoma (RCC) were treated in a phase I‐II trial with recombinant interferon alpha‐2b (α‐IFN) and vinblastine (VBL) in combination. Patients received IFN at a starting dose of 3 × 106IU/m2subcutaneously three times a week and VBL 0.1 mg/kg intravenously every 3 weeks, with dose modification for toxicity. All patients were evaluable for toxicity; 18 patients were evaluable for efficacy. An objective response rate of 44% was observed (eight of 18 patients, with one complete response and seven partial responses). The median duration of response was 5 months. The actuarial survival of responding patients was significantly longer than that of nonresponding patients. In general, the toxicity was tolerable; the subjective toxicity and fever were similar to that reported for the same doses of IFN alone. Only a mild neurotoxicity, usually mixed polyneuropathy, occurred with increased frequency. Alpha‐IFN and VBL administered at low doses in combination demonstrated the highest response rate so far reported in RCC without significa

ISSN:8756-0437    

DOI:10.1002/ssu.2980040309

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractThirty‐two patients with proven progressive metastatic renal cell carcinoma were treated with the combination of 0.1 mg/m2(2 × 106IU/m2) r‐interferon (r‐IFN)‐gamma and 6 μg/m2(2 × 106IU/m2) r‐IFN‐alpha. In case of progressive disease (PD) or stable disease (SD), after 8 weeks, the dose of r‐IFN‐alpha was escalated by 6 μg/m2every 2 weeks until the maximum tolerable dose was reached, while r‐IFN‐gamma was maintained at the low dose. The rationale for this study is provided by the dose‐related efficacy of IFN‐alpha as a monotherapy, the potent immuno‐stimulatory activity of IFN‐gamma, and the alleged synergistic effect of the combination. Fourteen patients are evaluable for 8 weeks of low‐dose combination treatment (7×SD, 5×PD, 2× early progression), while so far 6 of 24 patients (25%) who started dose escalation of IFN‐alpha have reached a partial response. These data indicate better efficacy with higher doses of IFN‐alpha. Because of the infrequent administration and the relative low doses, compared to other trials, the treatment regimen was well tolerated. Although preliminary results are promising

ISSN:8756-0437    

DOI:10.1002/ssu.2980040310

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractThe in vitro antitumor activity of alpha‐ and gamma‐interferon as well as tumor necrosis factor was tested on two human renal cell carcinoma xenografts—RC‐43 and NC‐65. A dose‐dependent inhibition of colony formation in soft agar was found for both tumor lines. NC‐65, however, showed no sensitivity for gamma‐interferon. Combination drug tests showed a synergistic effect on colony formation of both tumor lines. The strongest inhibition was shown by the combination of alpha‐interferon and tumor necrosis factor. We conclude that both interferons as well as tumor necrosis factor show direct in vitro cytostatic effects against renal tumor direct in vitro cytostatic effects against

ISSN:8756-0437    

DOI:10.1002/ssu.2980040311

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY