According to a recent article published in the Journal of Clinical Oncology, therapy utilizing a donor’s immune cells appears to provide anti-cancer activity in some patients with recurrent or refractory renal cell 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. Recurrent renal cell cancer (RCC) refers to cancer that has returned following previous therapies, and refractory RCC refers to cancer that has stopped responding to standard therapies. Currently available treatment options for recurrent or refractory RCC are limited and long-term survival for this group of patients remains suboptimal. Approximately 32,000 people in the United States are estimated to be diagnosed with RCC in 2003.
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 utilize immune activity as treatment for RCC in order to improve long-term survival in patients with this disease. One type of therapy being evaluated is the utilization of a donor’s immune cells. The donor’s immune cells are collected from a donor and infused into the patient in the hopes that the donor immune cells will recognize the cancer cells in the patient’s body as foreign and attack them. Unfortunately, the donor’s immune cells also often mount an attack against healthy cells in the patient’s body, which can cause life-threatening complications. This occurrence is referred to as graft-versus-host disease (GVHD). GVHD tends to occur more often when antigens (protein and/or carbohydrate sequences on cells), specifically human leukocyte antigens (HLA), do not match between donor and patient. Much research is ongoing in an attempt to reduce the risk of GVHD while maintaining anti-cancer effects derived from donor immune cells.
Researchers from New Jersey recently conducted a clinical trial evaluating the infusion of donor immune cells to patients with advanced cancers. The donor’s cells were only partially HLA matched and were irradiated prior to infusion into the patient in order to reduce the risk of GVHD. This trial involved 15 patients with advanced, recurrent or relapsed (stopped responding to standard therapies) cancers; 11 with RCC, 2 with melanoma and 2 with acute myeloid leukemia (AML). For the patients with RCC, 3 experienced cancer regression and 2 experienced cancer stabilization following donor immune cell infusions. Both patients with AML experienced cancer stabilization for approximately 4 months; however, both patients with melanoma experienced cancer progression during therapy. There was no apparent GVHD caused by treatment in any patient.
The researchers concluded that infusions of donor irradiated immune cells appear to produce anti-cancer effects in patients with recurrent or refractory RCC. Although HLA antigens were only partially matched between donor and patient, no evidence of GVHD occurred, as cells were irradiated prior to infusion. Patients with recurrent or refractory RCC may wish to speak with their physician about the risks and benefits of participating in a clinical trial further evaluating donor cell infusions or other promising therapeutic approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (cancer.gov) and www.cancerconsultants.com. Personalized clinical trial searches performed on behalf of patients is also available at cancerconsultants.com.
Reference: Strair R, Schaar D, Medina D, et al. Antineoplastic effects of partially HLA-matched irradiated blood mononuclear cells in patients with renal cell carcinoma.
Journal of Clinical Oncology. 2003;21:3785-3791.