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Metastatic Renal Cell Carcinoma: Response to Treatment with Human Recombinant Erythropoietin
- Jonathan Rubins, MD
- From Canandaigua Medical Group and F. F. Thompson Hospital, Canandaigua, New York. Requests for Reprints: Jonathan Rubins, MD, F.F. Thompson Hospital, 350 Parrish Street, Canandaigua, NY 14424. Acknowledgment: The author thanks Ms. Dawn Freeland for preparation of the manuscript.
Approximately 18 000 cases of renal cell carcinoma occur annually in the United States, and about 80% of patients with this condition eventually develop metastatic disease [1]. The prognosis for these patients is poor: They have a median survival time of about 12 months, and 0% to 20% survive for 5 years. Chemotherapy using infusional floxuridine produces response rates of 15% to 20%, but most responses are of short duration [2]. Immunotherapy using interferon-α or interleukin-2 results in similar response rates, although durable complete responses are seen more often with interleukin-2 [3]. Most patients fail to respond to these treatments and quickly die. More effective and less toxic therapies for renal cell carcinoma are urgently needed.
Case Report
A 40-year-old man presented in December 1992 with abdominal pain, weight loss, and fatigue. Eighteen months earlier, he had had a right nephrectomy for a 22-cm renal cell carcinoma (grade III-IV) that had invaded the renal capsule, the renal vein, and the inferior vena cava. No metastatic disease had been apparent at that time. On examination, the patient appeared pale and chronically …
