Prognostic factors of immunotherapy in metastatic renal cell carcinoma.

The prognosis of the majority of patients with metastatic renal cell carcinoma is poor, and there is no internationally recognized standard therapy for these patients. Patients are treated with interferon alpha or interleukin- 2 monotherapy, or combinations outside of clinical trials and a subgroup of patients responds to these therapies. Because immunotherapy induces adverse effects in almost every patient, it is necessary to avoid treating patients who will not, in the end, benefit from the treatment. It is therefore sensible to carefully select patients prior to the initiation of immunotherapy. Determining prognostic factors of survival or of rapid progression under treatment would be of help for selecting patients for immunotherapy. This article reviews current data about prognostic and predictive factors from immunotherapy studies in metastatic renal cell carcinoma comparing all analyzed factors with those that demonstrated an independent prognostic significance in multivariate analyses.