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    Immunotherapy May Improve Survival in Advanced Kidney Cancer

    There are some disturbing trends in kidney cancer in recent years: although more patients are being identified while their tumors are small, and being cured, the number of deaths from the disease is still increasing.

    "With early detection and improved surgical options, one would anticipate that overall survival for patients with kidney cancer would go up and mortality would go down," says Dr. Arie Belldegrun, chief of urologic oncology at the University of California at Los Angeles School of Medicine. "But that hasn't happened. Data published in 1999 show that the incidence of kidney cancer and mortality from kidney cancer are both going up."

    Speaking to fellow physicians at the annual meeting of the American Urological Association in Atlanta last week, Dr. Belldegrun explained that the number of patients being diagnosed with advanced kidney cancer and with cancer that's spread outside the kidney, is increasing. The more widespread and advanced a cancer, the harder it is to treat, and the greater the risk of death.

    But, says Dr. Belldegrun, recent research findings suggest that there's cause for hope for these patients. Combining surgery with immunotherapy, these studies report, can prolong the life of those with advanced kidney cancer, and possibly even eradicate the disease.

    His own research group has followed over 650 patients treated with aggressive surgery that removed the lymph nodes as well as the affected kidney in addition to immunotherapy with interleukin-2, a protein that helps the T cells in the immune system fight cancer.

    "The median survival of patients receiving the combination was 18 months versus six months for those who had surgery alone. And six percent of the patients had complete clinical remission," Dr. Belldegrun said. "For the first time, we can say that a patient had been cured of advanced kidney cancer."

    He cited two other studies that report similar findings. In a European trial, survival of patients treated with a combination of surgery and interferon, another immunotherapy agent, was better than that of patients treated with surgery alone. Another study from the Southwest Oncology Group, whose results were also presented at the conference, found that patients with advanced kidney cancer that received both immunotherapy with interferon and surgical removal of the kidney survived longer than those who received just the interferon did.

    Dr. Belldegrun concluded that with the increased use of this kind of combined therapy, survival for patients with advanced kidney cancer can be improved, and the trend of increasing deaths from the disease, can be reversed.



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