Management of renal cell carcinoma.

Surgical resection remains the cornerstone of management for localized renal cell carcinoma. No effective postsurgical adjuvant therapy has been established for patients with locally advanced disease who are at high risk for recurrence. The effective treatment of metastatic kidney cancer remains a challenge. Immunologic therapy with cytokines, such as interferon-alfa (Intron A, Roferon-A) and interleukin-2 (IL-2 [Proleukin]), benefit relatively small numbers of patients. Preclinical research and clinical investigations aimed at identifying new agents and treatment programs with improved antitumor activity against metastases remain the highest priorities in this refractory disease. New immunologic approaches to the treatment of both advanced and high-risk postsurgical disease are focusing on novel vaccine therapies to target both renal epithelial and vascular antigens.