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Isolated perfusion of the kidney with tumor necrosis factor for localized renal-cell carcinoma

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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-γ, 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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Authors and Affiliations

  1. Urologic Oncology Section, Surgery Branch, National Cancer Institute, National Institutes of Health, 20892, Bethesda, MD, USA

    M. M. Walther, S. B. Jennings, K. Hurley, W. Marston Linehan & S. A. Rosenberg

  2. Diagnostic Radiology Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, 20892, Bethesda, MD, USA

    P. L. Choyke

  3. Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, 20892, Bethesda, MD, USA

    M. Andrich

  4. Division of Urology, University of Maryland School of Medicine, 21201, Baltimore, MD, USA

    R. B. Alexander

Authors
  1. M. M. Walther
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  2. S. B. Jennings
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  4. M. Andrich
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  6. W. Marston Linehan
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  7. S. A. Rosenberg
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  8. R. B. Alexander
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Walther, M.M., Jennings, S.B., Choyke, P.L. et al. Isolated perfusion of the kidney with tumor necrosis factor for localized renal-cell carcinoma. World J Urol 14, S2–S7 (1996). https://doi.org/10.1007/BF00182056

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