Chemotherapy of adenocarcinoma of the kidney

Abstract

Despite the development of many new cancer chemotherapeutic programs, metastatic renal carcinomas have remained unresponsive either to single agents or combinations of agents. Extensive review of the literature and personal experience at Henry Ford Hospital have failed to find either a single agent or a combination of agents which produces consistent response rates. Single available agents which have been employed include; (a) A variety of alkylating agents—no response in 22 patients; (b) antimetabolites, including 5-fluorouracil, hydroxyurea, methotrexate, 6-mercaptopurine, and cytosine arabinoside—no significant response in 31 patients; (c) the antibiotics, including actinomycin D, mithramycin, adriamycin, and others—no response in 20 patients; (d) the periwinkle alkaloid antimitotic, Vincaleukoblastine—2 objective regressions in 15 patients. Newer investigative agents also have been unrewarding, with no objective remissions observed in 3 patients treated with dimethyl imidazole carboxamide, 3 patients treated with adriamycin, and 3 patients treated with 5-azacytidine. No responses were observed in 10 patients treated with the nitrosoureas. A review of the literature yields only occasional well-documented objective remissions with a variety of agents, primarily cyclophosphamide and hydroxyurea.