Renal cell carcinoma - historical

The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the NCCN Guidelines. Is there a regimen missing from this list? See the main RCC page for current regimens.

9 regimens on this page 9 variants on this page

Metastatic disease, first-line

Medroxyprogesterone acetate monotherapy

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Regimen

Study	Evidence	Comparator	Efficacy
Medical Research Council Renal Cancer Collaborators 1999 (MRC RE01)	Phase III (C)	IFN alfa-2a	Seems to have inferior OS

Note: to our knowledge, this regimen was not tested as an experimental arm in an RCT prior to becoming a standard comparator arm.

Hormonotherapy

• Medroxyprogesterone acetate (MPA)

References

1. Medical Research Council Renal Cancer Collaborators. Interferon-alpha and survival in metastatic renal carcinoma: early results of a randomised controlled trial. Lancet. 1999 Jan 2;353(9146):14-7. link to original article contans protocol PubMed

Vinblastine monotherapy

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Regimen

Study	Evidence	Comparator	Efficacy
Pyrhönen et al. 1999	Phase III (C)	Vinblastine & IFN alfa-2a	Inferior OS

Note: to our knowledge, this regimen was not tested as an experimental arm in an RCT prior to becoming a standard comparator arm.

Chemotherapy

• Vinblastine (Velban)

References

1. Pyrhönen S, Salminen E, Ruutu M, Lehtonen T, Nurmi M, Tammela T, Juusela H, Rintala E, Hietanen P, Kellokumpu-Lehtinen PL. Prospective randomized trial of interferon alfa-2a plus vinblastine versus vinblastine alone in patients with advanced renal cell cancer. J Clin Oncol. 1999 Sep;17(9):2859-67. link to original article PubMed

Metastatic disease, second-line

FC, then allo HSCT

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FC: Fludarabine & Cyclophosphamide

Regimen

Study	Evidence
Childs et al. 2000	Non-randomized, <20 pts

Chemotherapy

• Fludarabine (Fludara) 25 mg/m² IV once per day on days -5 to -1
• Cyclophosphamide (Cytoxan) 60 mg/kg IV once per day on days -7 & -6

Immunotherapy

• Allogeneic stem cells transfused on day 0

One course

References

1. Childs R, Chernoff A, Contentin N, Bahceci E, Schrump D, Leitman S, Read EJ, Tisdale J, Dunbar C, Linehan WM, Young NS, Barrett AJ. Regression of metastatic renal-cell carcinoma after nonmyeloablative allogeneic peripheral-blood stem-cell transplantation. N Engl J Med. 2000 Sep 14;343(11):750-8. link to original article contains verified protocol PubMed

Interferon alfa-2a monotherapy

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Regimen

Study	Evidence	Comparator	Efficacy
Aass et al. 2005 (EORTC 30951)	Phase III (C)	IFN alfa-2a & Retinoic acid	Seems to have inferior OS

Immunotherapy

• Interferon alfa-2a (Roferon-A)

References

1. EORTC 30951: Aass N, De Mulder PH, Mickisch GH, Mulders P, van Oosterom AT, van Poppel H, Fossa SD, de Prijck L, Sylvester RJ. Randomized phase II/III trial of interferon alfa-2a with and without 13-cis-retinoic acid in patients with progressive metastatic renal cell Carcinoma: the European Organisation for Research and Treatment of Cancer Genito-Urinary Tract Cancer Group (EORTC 30951). J Clin Oncol. 2005 Jun 20;23(18):4172-8. link to original article PubMed

Interferon alfa-2c monotherapy

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Regimen

Study	Evidence	Comparator	Efficacy
De Mulder et al. 1995 (EORTC 30885)	Phase III (C)	IFN alfa-2c & IFN gamma	Seems not superior

Immunotherapy

• Interferon alfa-2c

References

1. EORTC 30885: De Mulder PH, Oosterhof G, Bouffioux C, van Oosterom AT, Vermeylen K, Sylvester R. EORTC (30885) randomised phase III study with recombinant interferon alpha and recombinant interferon alpha and gamma in patients with advanced renal cell carcinoma. The EORTC Genitourinary Group. Br J Cancer. 1995 Feb;71(2):371-5. link to original article PubMed

Megestrol acetate monotherapy

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Regimen

Study	Evidence	Comparator	Efficacy
Ravaud et al. 2008	Phase III (C)	Lapatinib	Seems not superior

Note: to our knowledge, this regimen was not tested as an experimental arm in an RCT prior to becoming a standard comparator arm. Kelley & Baker 1961 examined a variety of progestins and is included for historic interest.

Hormonotherapy

• Megestrol acetate (Megace)

References

1. Ravaud A, Hawkins R, Gardner JP, von der Maase H, Zantl N, Harper P, Rolland F, Audhuy B, Machiels JP, Pétavy F, Gore M, Schöffski P, El-Hariry I. Lapatinib versus hormone therapy in patients with advanced renal cell carcinoma: a randomized phase III clinical trial. J Clin Oncol. 2008 May 10;26(14):2285-91. link to original article PubMed