Systemic therapy in metastatic renal cell carcinoma.

During the last two decades considerable advances have been made in the understanding of the biology of RCC. Although the best therapeutic options for patients with metastatic RCC have not been defined, it is apparent that use of immunomodulating cytokines like interferon-alpha and interleukin-2 either alone or combined with chemotherapeutic agents provides the best available results in routine clinical practice. Numerous studies have confirmed that objective tumour responses are seen only in a small fraction of patients (averagely in 15-20%). In spite of a lot of evidence that these treatments prolong survival, expectations of only 5-10% long-term survivals with complete and durable regression of tumours are realistic. Recently, some new promising investigational approaches have been reported. These may already in near future further improve overall treatment results.