Novel therapies for renal cell carcinoma - an update

This article reviews the recent progress in the search for new treatments for renal cell cancer (RCC), based on a variety of preclinical models or strategies. Some recent clinical trials addressing migrating treatments from other cancers onto RCC and novel agents are discussed, as well as the molecular targets for some of the novel agents. Drugs oriented to histologically definable RCC features, such as the G250 antigen, and the receptor tyrosine kinases, such as epidermal growth factor receptor, are reviewed. Drugs aimed at antiangiogenesis and perturbing features of the cell cycle are also mentioned, including preclinical and empirical experience. Molecular techniques in the study of von Hippel Lindau-related pathways and mRNA expression analyses are cited. Within the immune model of therapy, progress in the application of immune-related drugs including older cytokines (IL-2, IFN-alpha) and of newer cytokine-variant and other cytokines are discussed. Finally, cell-based therapies such as lymphocyte infusions, tumour-cell vaccines, dendritic cell vaccines and allogeneic mini-transplant are outlined. Although high percentage improvements in outcomes for metastatic RCC are not yet realised, the many fronts for scientific and clinical advances form some basis for optimism in the coming years.