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Allogeneic hematopoietic stem-cell transplantation: the next generation of therapy for metastatic renal cell cancer

Nature Clinical Practice Oncology volume 1, pages 32–38 (2004)Cite this article

Abstract

The management of metastatic renal cell carcinoma (mRCC) remains a therapeutic challenge; less than 10% of patients survive for longer than 5 years. The resistance of renal cancer to chemotherapy may be explained by high levels of the multidrug resistance gene, MDR1. Immune-based treatments for renal cancer have been explored because of their unusual susceptibility to immunological assault. However, response rates to cytokines such as interleukin-2 and interferon-α have ranged from only 10% to 20%, prompting other immunotherapy approaches, such as allogeneic stem-cell transplantation, to be investigated. Several clinical trials have provided evidence of partial or complete disease regression in refractory mRCC following nonmyeloablative stem-cell transplantation. This effect is because of a donor antimalignancy effect mediated by immunocompetent donor T cells, called graft-versus-tumor effect. Unfortunately, less than 30% of patients who could have this procedure will have a human-leukocyte-antigen-compatible sibling, and attention is focusing on alternative donors such as matched unrelated donors and partially mismatched related donors. Despite the improved safety of nonmyeloablative conditioning regimens, transplant-related toxic effects (particularly graft-versus-host disease) remain obstacles to the safe and effective use of this treatment. Regardless of these limitations, innovative approaches have attempted to harness the potential of the graft-versus-tumor effect in mRCC and other solid tumors.

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Author information

Authors and Affiliations

  1. Clinical Research Fellow and Specialist Registrar at The Institute of Urology, University College London,

    Manit Arya

  2. Consultant in Medical Oncology at Royal Free Hospital, London

    David Chao

  3. Consultant Uro-Oncological Surgeon, Department of Urology, Guys and St Thomas' Hospital, London, UK

    Hitendra RH Patel

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  1. Manit Arya
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  2. David Chao
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  3. Hitendra RH Patel
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Correspondence to Manit Arya.

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Arya, M., Chao, D. & Patel, H. Allogeneic hematopoietic stem-cell transplantation: the next generation of therapy for metastatic renal cell cancer. Nat Rev Clin Oncol 1, 32–38 (2004). https://doi.org/10.1038/ncponc0019

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  • DOI: https://doi.org/10.1038/ncponc0019

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