Prognostic factors and clinical trials of new agents in patients with metastatic renal cell carcinoma.

Metastatic renal cell carcinoma (RCC) remains a disease highly resistant to systemic therapy. Results of recent reports in the literature on prognostic factors and clinical trials for patients with metastatic RCC were reviewed. Small numbers of patients exhibit complete or partial responses to interferon and/or interleukin-2, but most patients do not respond and there are few long-term survivors. Therefore, the identification of new agents with better antitumor activity against metastases remains the highest priority of clinical investigation in this refractory tumor. Prospective identification of patients more likely to benefit from cytokine therapy could be used as a stratification factor in Phase III trials, and in risk-directed therapy.