Twenty patients with metastatic
renal cell carcinoma and nine patients with
minimal residual disease (MRD) but at high risk for recurrence following
nephrectomy received weekly four milligram
intradermal injections of purified
RNA extracted from lymphoid organs of sheep immunized with human
renal cell carcinoma. Eighty-six consecutive UCLA patients with metastatic
renal cell carcinoma served as retrospective controls. Survival between subpopulations in each group matched by computer according to extent and location of
metastases, age, sex, and interval between
nephrectomy and occurrence of
metastases were compared by Life Table Analysis. Survival was significantly greater in
RNA-treated patients (P < .05) who had multiple
metastases limited to the lungs when compared with matched controls.
RNA therapy did not influence survival of patients with
metastases to other sites (bone, brain, liver, lymph nodes, or skin) or multiple organ involvement. All nine MRD patients treated with
RNA remained free of recurrence for a mean observation period of 18 months, range ten to 34 months. No significant toxicity was observed. Changes in skin test responses were related primarily to
tumor burden. Increased lymphocyte mediated cytotoxicity in
RNA recipients was associated with a somewhat improved survival period. Changes in absolute lymphocyte counts had no correlation with
clinical course, and
complement fixing antibody generally decreased after excision of
tumor, was absent in patients with progression, and was present in low levels in patients with a favorable clinical response.
RNA therapy may be of value in selected patients with metastatic
renal cell carcinoma, and as an adjunct to definitive surgery.