Metastatic renal cancer and patient survival as a criterion of treatment response

Advanced metastatic renal cancer is an incurable disease, unless a successful excision of metastatic lesions can be performed. No effective treatment has yet been found. In the last few years, targeting therapies have been developed. In the past, the main treatment was based on cytokines (interferon-α or interleukin-2). Our objective was to determine the median and overall survival in the 66 patients who were studied and reviewed. All had histologically confirmed advanced renal cancer. There were 41 male and 25 female patients, with a median age of 60 years. In 68.18% of the patients, the treatment was mainly interferon-α (IFN-α) given 3 times a week for a median time duration of 6 months (range 3-12 months). Four patients received interleukin-2 (IL-2) and 17 patients received chemotherapy, 15 of whom had hormonal treatment. Eleven patients underwent palliative radiation therapy (in the bone or brain). Seven patients received no treatment apart from supportive care. A partial response was achieved in 11.11% of the patients treated with IFN-α. No response was observed in patients treated with chemotherapy or hormonal therapy. The median survival of all the patients was 20 months (95% CI 14.96-25.04). These results are discussed in comparison with the survival results of modern targeting treatment studies. In the latter studies, despite the high response rates (31-40%), the survival was 16.4 months. Our data indicate that the response rate as a criterion is not adequate in determining drug effectiveness.