Amin Asim, White Richard L
Divisions of Immunotherapy and Medical Oncology, Levine Cancer Institute, Carolinas Medical Center, Charlotte, North Carolina, USA; Divisions of Surgical Oncology and Immunotherapy, Levine Cancer Institute, Carolinas Medical Center, Charlotte, North Carolina, USA.
J Kidney Cancer VHL. 2014 Nov 23;1(7):74-83. doi: 10.15586/jkcvhl.2014.18. eCollection 2014.
Modulation of the immune response plays an important role in the natural history of renal cell carcinoma. Spontaneous regression of metastases has been well documented in a small percentage of patients after they undergo de-bulking nephrectomy without any additional systemic intervention. The only logical explanation for these observations is "resetting" of the balance between tumor and the host immune system that, having been overwhelmed by the tumor burden, is able to function better after tumor de-bulking. Attempts to modulate the activity of the immune system "on demand" have included the use of vaccines, cytokines/lymphokines, adoptive cell transfer, monoclonal antibodies and most recently manipulation of immune checkpoint inhibitors. Here we review the data for infusional interleukin-2 in the management of advanced renal cell carcinoma and its role in current clinical practice.
免疫反应的调节在肾细胞癌的自然病程中起着重要作用。在一小部分患者接受减瘤性肾切除术后，未经任何额外的全身干预，转移灶出现自发消退，这一点已有充分记录。对这些观察结果唯一合理的解释是肿瘤与宿主免疫系统之间的平衡“重置”，免疫系统在被肿瘤负荷压倒后，在肿瘤减瘤后能够更好地发挥作用。“按需”调节免疫系统活性的尝试包括使用疫苗、细胞因子/淋巴因子、过继性细胞转移、单克隆抗体，以及最近对免疫检查点抑制剂的操控。在此，我们回顾了输注白细胞介素-2在晚期肾细胞癌治疗中的数据及其在当前临床实践中的作用。
