Renal cancer
The inducing course of immunotherapy consists of 10 subcutaneous vaccinations (five at weekly and five at fortnight intervals) and takes about 3 months. The supporting vaccination schedule is determined by both a disease stage and a health state of a patient. The treatment is conducted on an outpatient basis.
The vaccine-induced, immune processes destroy the tumor cells and suppress the development of residual disease.
Xenogenic polyantigenic vaccine (XPV) is sterile.
The development of an influenza-like syndrome in the form of a body temperature rise up to 38°, but also and musculoskeletal discomfort are possible. Those symptoms are usually self-limited. The immunotherapy has no side effects attributable to chemoradiotherapy.
Xenovaccinotherapy for renal cancer
Therapeutic vaccination is a strategy that uses tumor-associated antigens to induce tumor-specific, immune responses. The xenogenic (murine) polyantigenic vaccine (XPV) -in which there are main families of common tumor-associated antigens - has been developed in the Institute of Clinical immunology. The small structural distinctions of xenogenic tumor-associated antigens from their human analogues render these antigens highly immunogenic and capable of stimulating immune-mediated, antitumor responses in a patient not only at early, but also at late stages of a disease, when tumor-derived immunosuppression is significant for more information.
Renal cancer has a high metastatic potential. Nearly 30% patients with renal cancer have the distant metastases at the moment of establishing the diagnosis. The appearance of metastatic lesions are noted in more than 20% patients following nephrectomy. The renal cancer is typically resistant to chemoradiotherapy. Therefore, immunotherapy pretends to the leading role in the systemic treatment for this disease.
According the available data (Davydov et al. 2006 ), the median survival in patients with disseminated renal cancer is typically on the order of 6–to-12 months, and the overall 2 year survival rate is nearly 10% . The data on survival of 18 XPV-treated patients (12 male, 6 female; age from 54-to-76) with IV stage renal cancer is shown in Figure 1.
Figure 1. Survival of the XPV-treated renal cancer patients (n=18)
As can be seen, nearly 50% XPV-treated patients survived longer than 4 years. The presented data are very encouraging. Nevertheless, they must be considered as preliminary because they are based on the follow-up of small number of patients.
The examples of applying xenovaccinotherapy for disseminated renal cancer are described below.
A 64-old female patient T (a history ¹ 2057) diagnosed with clear cell cancer of the right kidney (T4NxMx) (the condition after a surgical inspection of the abdominal cavity) started to vaccinate in October 2002. At that time there were complains of marked pains in the region of abdomen on the right. The elevated ESR (40 mm/h) was noted in the blood analysis. The excretory kidney function was not disturbed. As revealed by computer tomography (CT), a tumor (76 õ 60 õ 100 ìì) of the right kidney was intimately adjacent to the liver. The vaccinotherapy was well tolerated. After vaccination the induration of 30-to-40 mm usually developed in the injection site. At 3 months after vaccinotherapy initiation ERS reduced to norma (11 mm/h). UI revealed no sighs tumor growth. In the final analysis, at 2.5 years after vaccinotherapy initiation there was no evidence for disease progression.
A 61-old female patient Ò (a history ¹ 1003) firstly underwent a surgery for reason of developing cysts in the left kidney in November 1990. One month later this kidney was ablated. Metastases of clear cell hypernephroma cancer were detected in the right ovary in February 1993. The uterus with its appendages was surgically ablated and, after which, a course of immunotherapy with interferon was conducted. The sights of multifocal tumor lesions of the right kidney and adrenal gland were revealed by CT in November 2001. For this reason vaccinotherapy was initiated. In the final analysis, at 3 years after vaccinotherapy initiation the state of the patient was stable, there was no evidence for disease progression.
