Role of cytokine therapy for Renal Cell Carcinoma in the era of targeted agents

Abstract

Abstract For over two decades cytokines were considered the mainstay of treatment of locally advanced or metastatic RCC, due to lack of improved survival with either chemotherapy or hormonal therapy alone. Interferon-? (IFN-?)and Interleukin–2 (IL-2)have been the most evaluated cytokine agents but a low overall response rate and a marginal survival advantage coupled with significant toxicity make these therapies less than ideal. Although complete tumor responses have occasionally be seen with high dose IL-2, this therapy is associated with significant morbidity and mortality, and its approval has been based on limited non-randomized evidence. Newer anti-angiogenesis agents have been evaluated as single agents and as combination with IFN-? and are now considered the standard of care for most patients with RCC. However cytokines may still be occasionally recommended when angiogenesis inhibitors are not available or are contraindicated. In this paper, the evidence for the use of cytokine therapy in the setting of pre and post targeted therapy for RCC is discussed.