Heinzer H, Huland E, Huland H
Klinik und Poliklinik für Urologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg.
Urologe A. 2003 Nov;42(11):1450-2. doi: 10.1007/s00120-003-0444-y.
Interleukin-2 (IL-2) and/or interferon-alpha (IFN-alpha) induce remissions and prolong life in patients with metastatic renal cell carcinoma when carefully selected for a possibly toxic treatment. However, better-tolerated and more effective therapies are needed, especially in the elderly and patients with comorbidities. Recent achievements in the treatment of advanced renal cell carcinoma highlight potentially significant improvements. Immune cells within the tumor correlate with response and survival indicating the importance of local immune modulation. Such modulation has allowed introducing well-tolerated treatments such as inhalation of IL-2 to control lung metastases, which results in a significant survival benefit for high-risk patients as suggested by a recent cohort study in 200 patients. Antibody-based tumor targeting against cG250, specifically expressed on RCC, seems to stabilize progressive metastatic disease and does not induce toxicity. Vaccination strategies are also well tolerated, but have not shown convincing results in advanced disease so far. Other approaches have not fulfilled expectations. Stem cell transplantation still has significant toxicity and cannot be recommended for the elderly.
白细胞介素-2（IL-2）和/或α干扰素（IFN-α）在经过精心挑选以接受可能有毒性的治疗时，可诱导转移性肾细胞癌患者缓解并延长生存期。然而，需要耐受性更好且更有效的治疗方法，尤其是对于老年人和合并症患者。晚期肾细胞癌治疗的最新成果突出了潜在的显著改善。肿瘤内的免疫细胞与反应和生存相关，表明局部免疫调节的重要性。这种调节使得引入耐受性良好的治疗方法成为可能，如吸入IL-2以控制肺转移，最近一项针对200名患者的队列研究表明，这对高危患者有显著的生存益处。针对肾细胞癌特异性表达的cG250的基于抗体的肿瘤靶向治疗似乎可稳定进行性转移性疾病，且不诱导毒性。疫苗接种策略耐受性也良好，但迄今为止在晚期疾病中尚未显示出令人信服的结果。其他方法未达预期。干细胞移植仍有显著毒性，不推荐用于老年人。
