Interferon-alfa in the treatment of patients with inoperable locally advanced or metastatic renal cell carcinoma: a systematic review
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abstract
A systematic review was undertaken to determine whether interferon-alfa (IFN-α) is an effective treatment for patients with inoperablelocally advanced or metastatic renal cell carcinoma (mRCC).MEDLINE, EMBASE, the Cochrane Library, guideline databasesand relevant meeting proceedings were searched. Randomizedclinical trials (RCTs) or meta-analyses comparing IFN-α-containingregimens to placebo or non-immunotherapy controls, and thatreported response rate, survival, toxicity or quality of life data wereeligible. Two systematic reviews and eight RCTs met the selectioncriteria. A Cochrane review updated in 2005 reported higher responserates and reduced one-year mortality based on 4 RCTs in patientswho received IFN-α. Of the eight RCTs, three reporting objectiveresponse rate showed significant differences favouring IFN-α. Twoof five trials reporting survival data showed longer median survivalin the IFN-α group. Adverse effects of IFN-α were consistentacross the trials with increased intensity and frequency concordantwith increased IFN-α dose. Meta-analyses of seven RCTs forobjective response and six RCTs for mortality favoured IFN-α: oddsratio 6.87 (95% Confidence Interval [CI], 3.29 to 14.35) and hazardratio 0.79 (95% CI, 0.69 to 0.91), respectively. The effectivenessof IFN-α in mRCC has been subject to skepticism. As IFN-α
