Metastatic
renal cell carcinoma is notoriously resistant to
chemotherapy and
radiotherapy.
Immunotherapy with
interferon alpha is widely used for the disease, but its treatment effects are poor. A 69-year-old Japanese women presented with gross
hematuria. Imaging studies revealed a left renal
tumor, 12 cm in diameter, and multiple pulmonary and hepatic lesions. No abnormal laboratory data were observed other than
anemia with Hb 9.2 g/dl. Performance status was 0. She underwent radial left nepherectomy. Pathological examination showed
clear cell renal cell carcinoma with moderate histological differentiation (grade 2) and microscopic vessel invasion; pT3aN0M1 (Pul, Hep). Memorial Sloon-Kettering
Cancer Center classification was an intermediate risk due to
anemia. She received
interferon alpha, 5 million IU three times per week, postoperatively. In three months, hepatic lesions rapidly progressed although there was no interval change of pulmonary lesions. Then, the patient received
interferon alpha at the same dose as described above and half-dose
sorafenib, 400 mg per day. Grade 2
hypertension was under control by
calcium channel blocker and the
hand-foot syndrome was not obvious. No other grade 3/4
drug-related adverse events were observed. In one month after combination
therapy, not only pulmonary lesions but also hepatic lesions were smaller. She has received this combination
therapy with stable disease for six months. Performance status was 1 with grade 1
fatigue. The doses of this regimen may be tolerable, and might be an available treatment option for
interferon alpha-resistant advanced
renal cancer.