Isolated perfusion of the kidney with tumor necrosis factor for localized renal-cell carcinoma |
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| Authors: | M M Walther S B Jennings P L Choyke M Andrich K Hurley W Marston Linehan S A Rosenberg R B Alexander |
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| Institution: | (1) Urologic Oncology Section, Surgery Branch, National Cancer Institute, National Institutes of Health, 20892 Bethesda, MD, USA;(2) Diagnostic Radiology Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, 20892 Bethesda, MD, USA;(3) Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, 20892 Bethesda, MD, USA;(4) Division of Urology, University of Maryland School of Medicine, 21201 Baltimore, MD, USA;(5) Building 10, Room 2B-43, 10 Center Drive, MSC 1502, 20892-1502 Bethesda, MD, USA |
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| Abstract: | Summary Patients with localized renal-cell carcinoma who are candidates for renal parenchymal sparing surgery are being treated with isolated renal perfusion with recombinant human tumor necrosis factor (TNF). Isolated organ perfusion is a surgical technique that allows a cancer-bearing organ or region of the body to be treated with high doses of chemotherapy or biologic, agents that would not be tolerated systemically. In patients with in-transit melanoma or unresectable sarcoma, treatment with hyperthermic isolated limb perfusion using TNF, interferon- , and melphalan has resulted in response rates exceeding 90%. Because preclinical studies suggest that TNF may induce regression of tumors by causing hemorrhagic necrosis mediated by effects on tumor-related vascular endothelium, a vascular tumor such as renal-cell carcinoma could potentially be very responsive. A phase I study of escalating TNF doses delivered via isolated renal perfusion is currently being conducted. |
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