Spontaneous Regression of Metastases in a Case of Bilateral Renal Cell Carcinoma

Kallmeyer, J.C.; Dittrich, O.C.

doi:10.1016/s0022-5347(17)36537-0

Cited by 13 publications

(4 citation statements)

References 13 publications

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“…Although the causal role is not clear, transient pleural effusion and the withdrawal of INF‐α preceded the unexplained regression. Interestingly, Kallmeyer and Dittrich also reported a case of an RCC patient whose pleural metastasis regressed after the development of pleural effusion 3 …”

Section: Discussionmentioning

confidence: 99%

Enhancement of T cell proliferative response against autologous cancer cells of a metasatic renal cell carcinoma patient after unexplained regression

Kawai¹,

Saijo²,

Oikawa³

et al. 2004

Int J of Urology

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The unexplained regression of a metastasis of renal cell carcinoma (RCC) is rare phenomenon. While an immune mechanism has been proposed for spontaneous or unexplained regression of RCC, only limited data are available regarding immunological response. We report a case of a 62-year-old man with RCC whose paravertebral pleural tumor regressed after the withdrawal of interferon-a . In the present case, we demonstrate the enhancement of T cell proliferative response against autologous RCC cells secondary to the unexplained regression using the mixed-lymphocyte tumor culture. To our knowledge, the enhancement of an antitumor immunity secondary to an unexplained regression of RCC has not previously been reported.

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Section: Discussionmentioning

confidence: 99%

Enhancement of T cell proliferative response against autologous cancer cells of a metasatic renal cell carcinoma patient after unexplained regression

Kawai¹,

Saijo²,

Oikawa³

et al. 2004

Int J of Urology

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“…The high incidence of patients on placebo who achieved either a CR or PR raises specific questions about the evaluation of treatment response in patients with metastatic RCC. Spontaneous remission of RCC, as defined previously [4], has been reported in open‐label, non‐comparative clinical trials to have an incidence of 0–7% [13,22–35]. Typically, spontaneous remission occurs in men aged 30–76 years and the regression of lung metastases is most commonly reported [22–24].…”

Section: Discussionmentioning

confidence: 99%

“…Typically, spontaneous remission occurs in men aged 30–76 years and the regression of lung metastases is most commonly reported [22–24]. The incidence of spontaneous regression is greater after nephrectomy, but there has been unexpected complete regression after hormonal therapy or radiation therapy [26,27]. The reported duration of remission is variable, ranging from 3 months to 20 years.…”

Section: Discussionmentioning

confidence: 99%

Placebo‐associated remissions in a multicentre, randomized, double‐blind trial of interferon γ‐1b for the treatment of metastatic renal cell carcinoma

Elhilali¹,

Gleave

Fradet

et al. 2000

BJU International

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Objective To determine the validity of using an historical maximum spontaneous regression rate (reportedly 0±1.1% in those with lung metastases after nephrectomy) in clinical trials of treatments for patients with metastatic renal cell carcinoma (RCC), as the eligibility criteria for most studies will select patients with better performance status (and thus excluding those who are unlikely to respond) and more modern staging methods would potentially reduce the number of false-positives. Patients and methods A multicentre randomized, placebo-controlled, double-blind trial was recently completed in which 197 patients with metastatic RCC from 17 study centres across Canada were randomized to receive placebo or recombinant interferon c-1b (60 mg/m 2 ) subcutaneously once every 7 days until disease progression. All tumour responses were validated by an independent response committee unaware of the treatment. Results The median (95% con®dence interval) overall response rate (complete, CR, and partial, PR) for those on interferon-c was 4 (1.4±11.5)% and for those on placebo was 6 (2.5±13.2)% (P=0.75). In the six patients who were receiving placebo the CR and PR (three each) was considered to represent spontaneous remission. Of these six patients (aged 44±64 years) ®ve had undergone nephrectomy, one a tumour embolization, four had clear cell carcinoma and one an adenocarcinoma, and all had regression of lung and/ or lymph node metastases. Conclusion The lack of ef®cacy of interferon-c in this trial underlines the importance of continued research to identify alternative therapeutic agents or combinations of agents in phase II studies. However, the threshold response rate for initiating phase III trials should be increased to 18% in the phase II trials, i.e. three times the response rate on placebo.

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“…Spontaneous regression and response to immunotherapy are two unique characteristics of RCC [9, 10, 11, 12]which suggest that immune surveillance may be involved in the regression of this tumor. We used molecular techniques to investigate the relationships between HLA-DR antigens/alleles and RCC in Japanese patients.…”

Section: Introductionmentioning

confidence: 99%

HLA-DRB Genotypes in Japanese Patients with Renal Cell Carcinoma

et al. 2000

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Objectives: Several clinical features, such as the spontaneous regression of some renal cell carcinoma (RCC) metastases after nephrectomy, suggest immune involvement in tumor destruction. Patients and Methods: We investigated the role of genetic variation at the HLA class II loci in RCC by analyzing the HLA-DR antigen and HLA-DRB1, DRB3, DRB4 and DRB5 alleles in 55 patients using the polymerase chain rection. Results: No statistically significant differences were observed in the frequency of the HLA-DR antigen or HLA-DRB3, DRB4, or DRB5 genes between the patients and a healthy control group. On the other hand, the HLA-DRB1*0403 and *1202 alleles were significantly more frequent in the patients than in the controls (p < 0.001 and p < 0.01, respectively). Conclusion: RCC might be linked to these two alleles in Japanese patients.

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Spontaneous Regression of Metastases in a Case of Bilateral Renal Cell Carcinoma

Cited by 13 publications

References 13 publications

Enhancement of T cell proliferative response against autologous cancer cells of a metasatic renal cell carcinoma patient after unexplained regression

Enhancement of T cell proliferative response against autologous cancer cells of a metasatic renal cell carcinoma patient after unexplained regression

Placebo‐associated remissions in a multicentre, randomized, double‐blind trial of interferon γ‐1b for the treatment of metastatic renal cell carcinoma

HLA-DRB Genotypes in Japanese Patients with Renal Cell Carcinoma

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