Immunotherapy for Renal Cell Carcinoma

Dong Soo Park

doi:10.5124/jkma.2008.51.6.569

J Korean Med Assoc > Volume 51(6); 2008 > Article

Park: Immunotherapy for Renal Cell Carcinoma

Pharmacotherapeutics

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2008; 51(6): 569-576.

Published online: June 30, 2008

DOI: http://dx.doi.org/10.5124/jkma.2008.51.6.569

Immunotherapy for Renal Cell Carcinoma

Dong Soo Park, MD

Department of Urology, Pochon Cha University College of Medicine, Korea. dsparkmd@cha.ac.kr

Abstract

Since spontaneous regression of metastatic renal cell carcinoma (mRCC) has been reported, immunotherapy for mRCC has been the therapeutic option. The goal of modulating an immune response to the tumor cell with passive and/or active immunotherapy can be achieved through the increasing technological sophistication and the understanding of the immune system. Currently, among the several available cytokines to treat mRCC, high-dose interleukin-2 (IL-2) administration is the only way to obtain complete remission. However, due to the lack of prominent benefit and toxicity of high dose IL-2 therapy, cytokine-based immunotherapy for the treatment of mRCC is threatened by the intriguing molecularly targeted agents, which are still under the trials. Different types of cellular (autologous tumor cell, gene modified tumor cell, dendritic cell) and non-cellular therapeutic vaccines of mRCC have been applied in the clinical setting, and the success of clinical effectiveness in selected population has been reported. Future treatment approaches for mRCC or locally advanced RCC would be directed with combined therapy with immunotherapy and targeted agent. Additionally, molecularly targeted agents and vaccines modulating tumor immunology cascade will be another immunotherapeutic approach for RCC.

Carcinoma; Renal cell; Immunotherapy

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Figure 1

Evidence of host immune response in 73-year-old male renal cell carcinoma patient.

(A) low power, (B) high power.

Figure 2

Tumor immunologic response scheme.

Figure 3

Evidence of immunity related tumor of renal cell carcinoma after exposure to IL-2 therapy in 46-year old male patient.

(A) low power, (B) high power.

Table 1

Two major randomized trials of IL-2 therapy in advanced renal cell carcinoma

Table 2

Therapeutic tumor vaccines trials

TC: tumor cell, DC: Dendritic cell, CAIX: carbonic anhydrase IX, mRCC: metastatic renal cell carcinoma, BCG: bacillus Calmette-Guerin, KLH: keyhole limpet hemocyanin