Immune Cells May Improve Survival in Advanced Kidney Cancer
According to a recent article published in the journal Clinical Cancer Research, immune cells of a patient that are stimulated and reproduced through laboratory processes may improve survival in patients with metastatic renal cell (kidney) cancer.
The kidneys are a pair of bean shaped organs located on each side of the spine. The kidneys filter the blood and eliminate waste in the urine through a complex system of filtration tubules. All of the blood in the body passes through the kidneys approximately 20 times an hour. Renal cell cancer is an uncommon form of cancer that is most often characterized by the presence of cancer cells in the lining of the filtration tubules of the kidney. Metastatic renal cell cancer (RCC) refers to cancer that has spread from the kidney to distant and/or several sites in the body. Currently, the only approved agent for treatment of metastatic RCC is high-dose
Proleukin® , which is an agent that stimulates the immune system to attack the cancer. Approximately 32,000 people in the United States are estimated to be diagnosed with RCC in 2003. One-quarter of these patients will have metastatic RCC, with the average duration of survival for these patients being approximately one year, with less than 10% surviving 5 years.
Renal cell carcinoma tends to be responsive to treatment with immunotherapy, or therapy used to stimulate the immune system to attack the cancer. Thus, researchers have been evaluating novel ways in which to stimulate the immune system as treatment for RCC in order to improve long-term survival in patients with this disease. One area that has been under evaluation is the utilization of a patient’s own T-cells. T-cells are important cells of the immune system, and researchers are now able to force reproduction (expansion) and maturation of these cells in the laboratory. One method utilizing T-cells that is being evaluating includes the collection of a patient’s own T-cells from their peripheral (circulating) blood, which are stimulated to recognize the cancer cells as “foreign” and are reproduced in a laboratory and re-infused into the patient. Following re-infusion, these T-cells recognize and mount an attack against the cancer cells in the body.
Recently, researchers from the University of Washington and UCLA conducted a clinical trial evaluating the effectiveness of expanded T-cells plus Proleukin® in patients with metastatic RCC. Proleukin® was given to further stimulate the immune system against the cancer. This trial included 25 patients with metastatic RCC that had undergone previous nephrectomy (removal of kidney). Cells collected from the patient were stimulated in the laboratory for 8 days prior to infusion. Patients then received expanded T-cells plus Proleukin® on an outpatient basis. Overall, cancer was not reduced in size following therapy; however, the average duration of survival following therapy was 21 months, almost double the time historically achieved in patients with similar disease characteristics and extent. In addition, 2 patients had a significant regression in cancer that had spread to the bone. Side effects included flu-like symptoms and fever, which were mild to moderate.
The researchers concluded that T-cells that are stimulated and expanded in a laboratory and re-infused into the patient with Proleukin® may improve survival in patients with metastatic RCC. However, this technique needs to be evaluated further in future clinical trials in order to determine a true survival benefit. Patients with metastatic RCC may wish to speak with their physician about the risks and benefits of participating in a clinical trial further evaluating immunotherapy or other novel therapeutic approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (cancer.gov) and www.cancerconsultants.com. Personalized clinical trials are also performed by cancerconsultants.com on behalf of patients.
Reference: Thompson J, Figlin R, Sifri-Steele C, et al. A phase I trial of CD3/CD28-activated T cells (Xcellerated T cells) and interleukin-2 in patients with metastatic renal cell carcinoma.
Clinical Cancer Research. 2003;9:3562-3570.
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