Tailor - made vaccine hailed as milestone in renal - cell cancer

Arecent phase III study suggests that a novel autologous tumour-based vaccine could reduce disease recurrences in patients who have had surgery for renal-cell carcinoma (RCC). The results, published in the Lancet (2004; 363:594–559) show that the new tumour vaccine lowers the relative risk of metastases and/or relapse in RCC patients by approximately 30% and thereby may prolong their life expectancy. The German study is being hailed as a ‘milestone’, since it could “serve as a concrete step towards making adjuvant treatment of renal cancer a routine and effective intervention.” The study’s principal investigator, Professor Dieter Jocham of the University of Lübeck Medical School, Germany, is very excited about the results. “The significance of this study is that it’s the first ever to demonstrate the benefits of additive therapy for patients with RCC who don’t have metastasis, following surgery,” he said. “It’s also one of the first randomised controlled trials showing benefits for any autologous tumour vaccine.” RCC accounts for 2–3% of all malignancies, with the highest incidence occurring in the sixth decade of life. Of these, 70% are clear-cell tumours; less common cell types include papillary, chromophobe, and Bellini duct (collecting duct) tumours. The tumour occurs in both sporadic and hereditary forms (the latter accounting for approximately 10% of cases). In sporadic forms, spontaneous mutations have been found on chromosome 3. Smoking and obesity are both risk factors implicated in its development. Other risk factors include exposure to cadmium or asbestos, and long-term intake of diuretics. End-stage renal disease has also been associated with an increased risk of RCC, arising from acquired renal cysts. Professor Jocham adds pollution as a probable candidate for addition to this list of risk factors. “The incidence of RCC in the Western world is rising by 2–3% each year, and it’s likely that environmental pollutants contribute to this increase, although definite causes have yet to be identified,” he said.