Bukowski R M
Experimental Therapeutics, The Cleveland Clinic Taussig Cancer Center, OH, USA.
Semin Urol Oncol. 2001 May;19(2):148-54.
Cytokine therapy for patients with metastatic renal cancer is based on observations suggesting this neoplasm may be responsive to immunotherapy. Two cytokines, interferon-alpha (IFN-alpha) and interleukin 2 (IL-2) produce tumor regressions in 10% to 15% of patients with metastatic disease. Randomized trials demonstrate a modest survival advantage for patients treated with IFN-alpha. Combinations of IL-2 and IFN-alpha appear to be associated with improved response rates, but no demonstrable effect on survival. Additions of other cytokines (eg, GM-CSF) or chemotherapy to this combination has been investigated, but results do not suggest they enhance the outcome. Patient selection remains an important issue in this patient population. Individuals who are asymptomatic and have limited pulmonary or soft-tissue disease are most likely to benefit. The roles of immune dysregulation and the addition of novel cytostatic agents to these regimens are under investigation.
转移性肾癌患者的细胞因子治疗基于这样的观察结果，即这种肿瘤可能对免疫治疗有反应。两种细胞因子，即α干扰素（IFN-α）和白细胞介素2（IL-2），可使10%至15%的转移性疾病患者出现肿瘤消退。随机试验表明，接受IFN-α治疗的患者有适度的生存优势。IL-2和IFN-α联合使用似乎与更高的缓解率相关，但对生存无明显影响。已研究将其他细胞因子（如粒细胞巨噬细胞集落刺激因子）或化疗药物加入该联合治疗方案，但结果并未表明它们能改善治疗效果。在这类患者群体中，患者选择仍然是一个重要问题。无症状且肺部或软组织疾病局限的个体最有可能从中获益。免疫失调的作用以及在这些治疗方案中添加新型细胞生长抑制剂的研究正在进行中。
