Kidney Cancer

Although high-dose interleukin-2 (IL-2, Proleukin), a highly toxic agent used in the treatment of renal cell carcinoma and melanoma, was initially associated with treatment-related mortality, it can, in the appropriate

Flavopiridol [2-(2-chlorophenyl 5 ,7-dihydroxy-8-[cis-(3-hydroxy-1-methyl-4-piperidinyl)-4H-1-benzopyran-4-one, hydrochloride] is a semisynthetic flavone with a novel structure compared with that of polyhydroxylated flavones, such as quercetin and genistein.[1] It is derived from rohitukine, an alkaloid isolated from the stem bark of Dysoxylum binectariferum, a plant indigenous to India.[2] Originally synthesized and supplied by Hoechst India Limited, flavopiridol is provided to the Division of Cancer Treatment and Diagnosis of the National Cancer Institute (NCI) by Aventis Pharmaceuticals, Inc.

Phase II studies of single-agent docetaxel (Taxotere) yielded promising results in advanced or metastatic transitional cell carcinoma (TCC) of the urothelium. Antitumor responses have been demonstrated in previously treated and chemotherapy-naive TCC patients, as well as in a subgroup of patients with renal impairment unable to receive traditional cisplatin-based regimens.

A 68-year-old man is referred for further evaluation and treatment of jaundice. He describes pruritus, intermittent mild midabdominal discomfort, and progressive weight loss. There is no history of fever. His history is significant for renal cell carcinoma with pulmonary metastasis.

ANAHEIM, California-Percutaneous radiofrequency ablation, which is FDA-approved for treating liver and soft tissue neoplasms, may also be useful in renal cell carcinoma, according to several reports from the American Urological Association annual meeting.

SAN FRANCISCO-Trials employing outpatient use of subcutaneous (SC) interleukin-2 (IL-2, Proleukin) in lower doses suggest that the overall response rate in metastatic renal cell carcinoma is adversely affected by the decrease in dose or the subcutaneous route of administration.

Preliminary results of a phase III trial of high-dose recombinant human interleukin-2 (IL-2, Proleu kin) demonstrated increased response rates with a longer median duration, compared to outpatient subcutaneous IL-2 in conjunction with

BMS-247550 is a methyl, semi-synthetic analog of the natural product epothilone B. Provided to the National Cancer Institute (NCI) by Bristol-Myers Squibb, BMS-247550 was chosen for clinical development because it demonstrated

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.