Kidney Cancer

With the understanding of the mechanism of malignant transformation has come the knowledge that oncogene products are frequently growth factors, growth factor receptors, or elements of growth factor signal-transduction pathways. Overexpression

A pilot study was performed at The University of Texas M. D. Anderson Cancer Center to determine the feasibility of using thalidomide in a population of renal-cell carcinoma patients who had progressive disease despite chemotherapy and immunotherapy. Metastatic renal-cell carcinoma patients with adequate oral function were entered onto a study after signing an internal review board-approved informed consent. There were no exclusion criteria for prior therapy. Nineteen previously treated patients and one untreated patient with progressive renal-cell carcinoma received oral thalidomide as a single agent. The starting dose was 200 mg and the dose was increased by 100 to 200 mg every week until it reached 1,200 mg/d. Response was assessed on the basis of a radiographic reduction of the metastatic sites involved. A case report describing one of the patients involved in the pilot trial is included. [ONCOLOGY 14(Suppl 13):33-36, 2000]

BETHESDA, Md-In a pilot study, 10 of 19 patients with advanced renal cell cancer had a response to nonmye-loablative allogeneic peripheral blood stem cell transplantation, reported Richard Childs, MD, of the National Heart, Lung, and Blood Institute.

Thalidomide (Thalomid) has antiangiogenic and immunomodulatory properties with activity in myeloma and other tumors. We treated 15 patients with advanced progressive metastatic renal-cell cancer with escalating divided daily doses of thalidomide

MAYWOOD, Ill-Removing the cancerous kidney before administering interferon alfa-2b (Intron A) improves survival in advanced renal cancer, according to results of Southwest Oncology Group (SWOG) Trial 8949. The role of interferon treatment, however, remains controversial.

ASCO-Cytoreductive nephrectomy prior to interferon-alfa-2b (Intron A) therapy increased survival by 50% in patients with previously untreated metastatic renal cell cancer, compared with interferon alone, Robert Flanigan, MD, reported at the plenary session of the 36th Annual Meeting of the American Society of Clinical Oncology in New Orleans.

ATLANTA-A fluorescent marker given 4 hours before surgery lights up renal cell carcinoma cells and eliminates the need for frozen sections to guarantee clean margins during kidney-preserving tumor resection, German researchers reported in a poster presented at the 95th Annual Meeting of the American Urological Association (AUA).

An ongoing phase I clinical trial shows that a new anticancer agent, CCI-779, is well-tolerated and may have antitumor activity. CCI-779 is a derivative of rapamycin, an immunosuppressive agent. Results of the study were presented at the

Renal cell carcinomas include a group of epithelial neoplasms, such as clear-cell and papillary carcinomas, that continue to pose significant management challenges in patients

Surgical resection remains the cornerstone of management for localized renal cell carcinoma. No effective postsurgical adjuvant therapy has been established for

Drs. Wolchok and Motzer provide a succinct, timely review of the diagnosis and management of renal carcinoma. The article leads us to ask a number of questions: What factors account for the major increase in the incidence of renal carcinoma? How has surgical management evolved with the advent of newer operative techniques? What role, if any, does chemotherapy play in the treatment of this disease? What is the current status of and future outlook for immunotherapeutic approaches?

BETHESDA, Md-Some kidney cancer patients in an ongoing phase II trial of an experimental antiangiogenesis monoclonal antibody have shown improvement. The randomized, three-arm study by National Cancer Institute researchers compares two different doses of the drug against a placebo.

Often overshadowed by more common genitourinary cancers, such as prostate, testicular, and kidney cancers, penile and urethral cancers nonetheless represent difficult treatment challenges for the clinician. The management of these cancers is slowly evolving. In the past, surgery, often extensive, was the treatment of choice. Recently, however, radiation and chemotherapy have begun to play larger roles as initial therapies, with surgery being reserved for salvage. With these modalities in their treatment armamentarium, oncologists may now be able to spare patients some of the physical and psychological sequelae that often follow surgical intervention without compromising local control and survival. Part 1 of this two-part article, published in last month’s issue, dealt with cancer of the penis. This second part focuses on cancer of the urethra in both females and males. [ONCOLOGY 13(11):1511-1520, 1999]

Many patients with kidney cancer who had been exposed to high levels of trichloroethylene have a unique pattern of genetic mutations within their cancerous cells. These findings were reported by Hiltrud Brauch, PhD, of the University of Hamburg,

WASHINGTON-“The possibility of spontaneous regression suggests that immunotherapy is a valid route to pursue in kidney cancer research,” said Ronald M. Bukowski, MD, director of the experimental therapeutics program at the Cleveland Clinic Cancer Center.

WASHINGTON-“Enough evidence has accumulated to suggest that interleukin-12 [IL-12] deserves continued study in kidney cancer and other malignancies, even though it has had a difficult track record so far,” Janice P. Dutcher, MD, said at the 1999 Kidney Cancer Association Annual Convention. Dr. Dutcher is associate director for clinical affairs, Our Lady of Mercy Cancer Center/New York Medical College.

WASHINGTON-Monoclonal antibodies are the basis of many diagnostic tests, but now are catching on as therapy as well, said Neil Bander, MD, surgical director, Urologic Oncology Program, Cornell University and New York Presbyterian Hospital, New York. “This particular type of approach has now been validated clinically and is being used to treat patients with various types of cancer,” Dr. Bander said at the Kidney Cancer Association Annual Convention.

Very little has changed in the management of advanced renal cell carcinoma since the approval of interleukin-2 (IL-2, aldesleukin [Proleukin]) in 1992 by the FDA for the systemic treatment of this disease. Dr. Bukowski succinctly reviews the

Patients with metastatic renal cell carcinoma continue to present a therapeutic challenge. Current therapeutic approaches involve surgery and various types of immunotherapy. The rationale for this latter form of therapy

CLEVELAND, Ohio-The importance of the spiritual domain in comprehensive patient care was emphasized during the care of Mrs. S, a 64-year-old woman with renal cell carcinoma with bone metastasis, Cathy Palcisco, LISW, said at a symposium on palliative medicine held at the Cleveland Clinic Foundation.

Renal cancer occurs in nearly 10 of every 100,000 people in the United States and in approximately 45 of every 100,000 of those over 65 years of age. Standard treatment is open surgery, often involving total removal of the tumor along with the kidney. However, a study in the September issue of the Journal of Ultrasound in Medicine reports that ultrasound-guided renal cryoablation is a feasible technique for treating renal malignancies while still preserving the renal parenchyma.

Renal cancer occurs in nearly 10 of every 100,000 people in the United States and in approximately 45 of every 100,000 of those over 65 years of age. Standard treatment is open surgery, often involving total removal of the tumor along with the

BETHESDA, Md-Proleukin (al-desleukin, Chiron) has won the backing of the Oncologic Drugs Advisory Committee (ODAC) for a new indication. The panel recommended that the FDA approve the recombinant human inter-leukin-2 as “indicated for the treatment of adult patients with metastatic melanoma.” The FDA approved Proleukin for use in renal cell carcinoma in 1992.

SAN FRANCISCO-The use of interleukin-2 (IL-2, Proleukin) in hematologic malignancies is much less advanced than similar work in metastatic melanoma or renal cell carcinoma.

SAN FRANCISCO-Interleukin-2 is proving to be one of the most effective treatments yet discovered for renal cell carcinoma. Speaking at the Proleukin First International Congress, sponsored by Chiron Corporation, Richard I. Fisher, MD, director of Loyola University’s Cardinal Bernadin Cancer Center, Maywood, Ill, dubbed IL-2 “the new gold standard against which other treatments need to be compared.”