Active immunotherapy mobilizes the patient's own immunity against renal cell carcinoma cells — including metastatic forms of the disease.
Kidney cancer has a high metastatic potential. Approximately 30% of patients already have distant metastases at the time of diagnosis, and more than 20% of patients develop metastatic foci at various times following nephrectomy.
Systemic treatment for this category of patients is challenging: kidney cancer is resistant to chemotherapy and radiotherapy. According to published data (Davydov et al., 2006), the median survival of patients with distant metastases is 6–12 months, and only 10% survive for 2 years.
The best results from immunotherapy are to be expected when treatment is initiated immediately after the conditionally radical removal of the primary tumor.
Survival data for patients with stage IV disease. The results were obtained from a small group of patients with advanced stages of the disease and are considered encouraging.
stage IV patients under observation
12 men and 6 women, ages 54–76
observation period for the group
survival results are considered encouraging
survive 2 years on standard treatment
benchmark according to Davydov et al., 2006
Clinical cases demonstrate the possibility of prolonged disease stabilization in metastatic kidney cancer.
Patient T., 61 years old
Post-left nephrectomy status, multifocal lesions
Baseline
Ultrasound and MRI revealed signs of a multifocal tumor lesion in the right kidney and right adrenal gland (focus 29 × 31 mm). Vaccine therapy was initiated in an intensified regimen; the patient tolerated the treatment well.
First months
On the first day after vaccination — subfebrile temperature, hyperemia at the injection site (7–9 cm). After 3 months, ESR dropped to normal (11 mm/h), and a relative lymphocytosis of 31% was noted.
Dynamics
Subsequent examinations at 3-month intervals showed no data for progression. After 2.5 years, the condition is stable, Karnofsky performance status is 90%.
Observation period
After intensifying therapy when a new focus appeared, the condition stabilized. No signs of disease progression were noted after 3 years.
Stabilization — observed for 3 years without progression
Patient T., 64 years old
Clear cell carcinoma of the right kidney T4NxMx
Baseline
Complaints of pain in the right lumbar region, worsening with movement. ESR elevated to 40 mm/h. CT showed a heterogeneous mass in the upper pole of the right kidney, 76 × 60 × 100 mm.
Start of therapy
Vaccine therapy was started. Pain and hyperemia 3 × 4 cm at the injection site, lasting for a day: the local reaction reflects immune response activation.
The best results are expected when immunotherapy is initiated right after the conditionally radical removal of the primary tumor — for relapse prevention.
Immunotherapy effectively complements the surgical method and reduces the depressive effect of the tumor on the immune system.
The method lacks the pronounced toxicity inherent in chemotherapy and radiotherapy, and does not limit the patient's daily activity.
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