Immunotherapy In Renal Cell Carcinoma

With contributions by numerous experts

Kidney Cancer: Principles and Practice is a comprehensive and interdisciplinary textbook that encompasses all clinically relevant aspects of the disease. This new edition has been extensively updated and includes brand new material covering the most recent developments in kidney cancer diagnosis and therapy. The user-friendly and clinically oriented content of the book guarantees that it will be of great interest to a wide range of medical professionals, and every effort has been made to ensure that contributions are both easy to understand and directly related to patient care. Content presentation departs from the usual dense chapter format featuring a lengthy series of paragraphs. Instead, each chapter contains several boxed sections, including one that summarizes essential "take home points" for the busy clinician and another that presents a patient-oriented case highlighting the clinical application of elements discussed in that chapter. In addition, accessible original images, illustrations, and diagrams (some in full color) are used to simplify particularly complex material. This book will be of value for clinicians, researchers, residents, fellows, students, and knowledgeable lay people. The contributors comprise an international group of authors with expertise in kidney cancer epidemiology, molecular biology, pathology, diagnosis, clinical features, staging, prognostic and predictive factors, surgery, systemic therapy, and emerging investigational approaches, among others.

Despite the rising popularity of the minimally invasive laparoscopic option, open nephron-sparing surgery is still seen by many experts as the 'gold standard' for open surgery for kidney tumors and should remain the first choice for many patients. This challenges the idea that less-invasive therapies are always more desirable than open surgery. Whi

The management of advanced renal cell carcinoma is still problematic. Surgery, although the therapy of choice for locally advanced renal tumors, is still controversial as the treatment for metastases. The role of surgery in the management of patients with pulmonary, bony, and liver metastasis is one of the subject matters discussed in this book. Our results with series of patients undergoing resection of metastases from the lung, bone, and liver show that surgery may be appropriate in selected patients with a good performance status, although most of them certainly cannot be cured by this procedure alone, i.e., in the absence of effective adjuvant therapies. As recent developments show, new strategies for immunotherapy of renal cell carcinoma represent a modest advance over traditional approaches in the treatment of this cancer, such as chemo- and radiotherapy. Clinical trials employing recombinant interferon-a and interleukin 2 produced response rates in up to 30% of patients treated, as evidenced by the European Immunotherapy Trials Program. The adverse reactions and the lack of efficacy in the majority of patients warrants the search for new immunotherapeutic approaches.

This reference brings together all aspects of renal cell carcinoma, and provides a basis for understanding the disease's origin, progression and responses to immunotherapy.;Examining the current status of cytokine, cell-based and chemotherapeutic methods of treatment, this book: discusses the clinical presentation of advanced renal carcinoma and its therapeutic challenges; reviews prognostic factors and the management of renal cell carcinoma occurring with von Hippel-Landau syndrome; summarizes efforts to identify the tumour suppressor gene deleted from chromosome 3 in most renal cell carcinomas; explicates the role of oncogenes in the progression of renal cell cancer and the molecular correlates of responses to interferon-alpha treatment; details the latest laboratory efforts to establish gene therapy for tumour treatment by transfection of cytokine genes in murine model systems; focuses on biologic response modifier therapy in humans, including cell-mediated immune responses and adoptive immunotherapy; presents preclinical and clinical studies of interleukin-2 alone, in combination with othe cytokines, and with chemothrapeutic agents; and addresses studies on the tumour necrosis factor and low- and high-dose interferon-alpha.

Advanced Renal Cell Carcinoma (RCC) cannot be cured by surgery alone. Its resillience to irradiation and chemotherapy demands a new approach to the management of this disease. This book provides an overview of the scientific and clinical developments of RCC, and clarifies the fields ofimmunotherapy and immunobiology. The book contains a compilation of approaches that will enhance the effectiveness of the management of advancedRCC, even in the absence of definitive pre-clinical data. These require additional study and will stimulate the reassessment of preliminary results.Furthermore, preliminary results of already implemented clinical trials withbiological modifiers are presented. Of special interest are the current achievements in the field of immunotherapy using topically and subcutaneously low dosage combinations of cytokines. This concise volume will benefit those seeking a thorough review of the research and the clinical aspects of RCC simultaneously.