The Use of Cytokines, Tumor Infiltrating Lymphocytes, and Gene Therapy in the Treatment of Advanced Renal Cell Carcinoma: The UCLA Experience
The approach to disseminated renal cell carcinoma (RCC) has evolved significantly in the past decade, largely due to availability and efficacy of biologic therapy. Since Rosenberg first reported the use of Interleukin 2 (IL-2) and lymphokine activated killer cells (LAK) in advanced RCC1, numerous combinations of cytokines and lymphoid cells have been used in treatment of RCC with varying success. Currently, high dose IL-2 remains the only FDA approved agent for biologic therapy of RCC. However, most renal cell carcinoma patients fail to benefit from IL-2 and toxicity when administered in high dose bolus fashion is considerable. In an effort to improve response rate and decrease toxicity, we have employed the use of combination low dose IL-2 and IFNα with and without ex vivo expanded tumor infiltrating lymphocytes (TIL). We are also investigating the potential utility of gene therapy for development of a tumor vaccine, as well as target directed cytokine delivery. This chapter summarizes some or our experiences with cytokine therapy, adoptive immune therapy with TIL, and gene therapy.
KeywordsToxicity Adenocarcinoma Oncol Interferon Laminin
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