A Long-term survival in a 10-year-old girl with widely metastatic renal cell carcinoma treated with immunotherapy
Elżbieta Drożyńska, Ewa Bień, Katarzyna Połczyńska, Ewa Iżycka-Świeszewska, Anna Balcerska
CaseRepClinPractRev 2003; 4(4):331-334
Background: Renal cell carcinoma RCC is a rare malignancy of childhood. The experience with management of RCC is very limited with no therapy protocol entirely recommended for a widespread disease. The clinical significance of immunotherapy based on recombinant interleukin (rIL-2) and interferon alpha (IFNa) in children with metastatic RCC has not been defined so far.
Case Report: We present a medical history of a 10-year-old girl diagnosed of stage IV RCC (tumor of the right kidney and multiple metastases to the lymph nodes and lungs). After irradical tumor resection and some ineffective chemotherapy schemes the patient has been given an immunotherapy protocol including high-dose intravenous rIL-2 and sublingual form of
IFNa. Four cycles of rIL-2 and administration of oral IFNa produced a long-term stabilisation of lung metastases which has led to significantly prolonged survival time (over 10 years from diagnosis).
Conclusions: It is not evident if the stabilisation of RCC in our patient has resulted from immunotherapy regimen or perhaps represents a case of spontaneous partial regression of cancer. It is also a matter of debate if oral form of IFNa has had any impact in disease stabilisation, as the
bioavailability of this route of IFNa administration is rather doubtful. In light of the very low incidence of RCC in childhood, prospective multicenter studies will be required to define the role of adjuvant immunotherapy in this malignancy.
Keywords: renal cell carcinoma, metastatic disease, Immunotherapy, high-dose intravenous rIL-2, sublingual INFa, long-term survival