The immune system is responsible for protecting you from viruses, bacteria, and cancer cells. Immunotherapy involves the use of drugs and laboratory techniques to make the immune system more active so immune cells attack and kill cancer cells. Immunotherapy is the main approach to treating metastatic kidney cancer.

Improper immune system function can contribute to many diseases and disorders. An under-active or suppressed immune system may not detect and eliminate malformed cells, allowing the formation of tumors and cancer. An over-active immune system may attack healthy parts of your body causing some forms of rheumatoid arthritis and diabetes, and auto-immune diseases.

Many different types of immune cells are involved in fighting cancer, including: NK cells, T cells, called CD8 cells and CD4 cells, tumor infiltrating lymphocytes, antigen-processing cells, and others.

In general, three types of proteins are produced by the immune system: interferons, interleukins, and antibodies. These are naturally occurring substances in your body which function in many different ways. There are at least twenty types of interferons. The most common are alpha, beta and gamma interferon. There are at least seventeen interleukins. Dozens, if not hundreds, of antibodies are also produced by your immune system to fight cancer and disease. By manufacturing these proteins using biotechnology, it is now possible to treat kidney cancer with these substances, called biological response modifiers (BRMs).

Biological therapy (sometimes called immunotherapy, biotherapy, or biological response modifier therapy) is a relatively new addition to the family of cancer treatments that also includes surgery, chemotherapy, and radiation therapy. Biological therapies use the body’s immune system, either directly or indirectly, to fight cancer or to lessen the side effects that may be caused by some cancer treatments.

Kidney cancer develops most often in people over 40, but no one knows the exact causes of this disease. The cancer of the kidney represents 5 000 new cases in France per year, with an increase in the incidence of 3% per year.

RCC (renal cell carcinoma) is one of the few cancers which has been found to be susceptible to immunotherapy. Immune stimulating drugs such as Interleukin-2 and Alpha Interferon are the mainstay of current pharmaceutical treatment and immunotherapy. In particular, Interleukin-2 based therapy sometimes yields very long term remissions and apparent cures.

Chronic myelogenous leukemia (CML) is one of a group of diseases called the myeloproliferative disorders. The median survival is 4 to 6 years, with a range of less than 1 year to more than 10 years. Survival after development of an accelerated phase is usually less than 1 year and after blastic transformation is only a few months. CML is a clonal disorder that is usually easily diagnosed because the leukemic cells of more than 95% of patients have a distinctive cytogenetic abnormality, the Philadelphia chromosome (Ph1). The Ph1 results from a reciprocal translocation between the long arms of chromosomes 9 and 22 and is demonstrable in all hematopoietic precursors [1]. This translocation results in the transfer of the Abelson (abl) on chromosome 9 oncogene to an area of chromosome 22 termed the breakpoint cluster region (BCR). This in turn results in a fused BCR/ABL gene and in the production of an abnormal tyrosine kinase protein that causes the disordered myelopoiesis found in CML. Furthermore, these molecular techniques can now be used to supplement cytogenetic studies to detect the presence of the 9;22 translocation in patients without a visible Ph1 (Ph1-negative).

Treatment of chronic myelogenous leukemia (CML) is usually initiated when the diagnosis is established, which is done by the presence of an elevated white blood cell (WBC) count, splenomegaly, thrombocytosis, and identification of the BCR/ABL (breakpoint cluster region/Abelson) translocation.

1. Interferon alpha (IFNa) + cytarabine as initial therapy gives a 10- 38% responses.

2. Since tyrosine kinase activity is required for the transforming function of the BCR/ABL (breakpoint cluster region/Abelson) fusion protein, a specific inhibitor of the kinase could be an effective treatment for patients with CML. Imatinib mesylate (Gleevec/Gilvac, Imatinib)  is a compound that inhibits the BCR/ABL oncoprotein, which is pathogenic in CML.

2. The only consistently successful curative treatment of chronic myelogenous leukemia (CML) has been high-dose therapy followed by allogeneic bone marrow or stem cell transplantation. However, many patients are not eligible for this approach because of age, comorbid conditions, or lack of a suitable donor. In addition, there is substantial morbidity and mortality from allogeneic bone marrow or stem cell transplantation; a 15% to 30% treatment-related mortality can be expected, depending on whether the donor is related and on the presence of mismatched antigens.