Action to Cure Kidney Cancer

There were two renal cell TroVax studies presented at ASCO, an oral presentation by Howard Kaufman of Columbia University and a poster by Robert Hawkins of The Christie Hospital, Manchester, UK.

5T4 is a protein that is over-expressed in 90% of renal cell tumors including clear cell and papillary but not in other cancer types. Simply stated, TroVax is a 5T4 vaccine that has the objective of stimulating the immune system to attack the tumor.

Columbia University Trial

In the Columbia University Phase II trial, 25 patients (21 clear cell and 4 papillary) entered the trial, to be treated with the combination of high-dose Interleukin-2 (HD IL-2) and TroVax. The maximum treatment level, if tolerated, was 8 vaccinations and 4 cycles of IL-2. All but one patient had had prior therapies.

Interleukin-21 is a protein that has a regulatory effect on the body's immune system by activating T-cells and natural killer (NK) cells, which normally target cancer cells for destruction. It is similar to Interleukin-2 in this respect, however, IL-2 induces proliferation of regulatory T (T-reg) cells, which are immune suppressor cells that are necessary to keep the immune system from attacking healthy body tissue but may have a dampening effect on the ability of IL-2 to fight tumors. IL-21 does not enhance proliferation of T-reg cells.

There are three recent IL-21 trials of interest:

Sunitinib (Sutent) in Patients with Brain Metastases

Pfizer Researcher Dr. Subramanian Hariharan and his associates presented a poster on the efficacy of sunitinib (Sutent) as a first-line treatment in RCC patients with brain metastases, a historically under-represented and under-treated group. Sunitinib is an oral multi-targeted, tyrosine kinase inhibitor that blocks the VEGF and PDGF angiogenesis pathways, preventing tumors from growing blood vessels. It is an FDA-approved drug for RCC and has demonstrated high efficacy as a first-like treatment for RCC patients compared to interferon-alpha (IFN), with a median progression-free survival (PFS) of 11 months compared to IFN's 5 months) and an Objective Response Rate of 37% compared to 9% with IFN.

Report from ASCO 2008

34,000 people attended this year's ASCO Conference in Chicago, IL. Of those, 26,600 were professionals, i.e. oncologists, oncology nurses, pharmacologists, and other health care professionals. Most of the others were exhibitors. International attendees, representing 117 countries, outnumbered domestic ones by 53% to 47%.

With respect to kidney cancer, three were neither surprises nor exceptional revelations in the more than 100 abstract presented in kidney cancer. There is a steady progression of work being done in targeted therapies, which is understandable given the early successes of sunitinib (Sutent) and sorafenib (Nexavar). We are reporting on updates to drug trials that have been ongoing for the last few years, including the first overall survival data coming out of a sunitinib trial, as well as some new treatments including immunotherapies.

Following are summary reports of selected oral and poster sessions.

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• Volume 1 Number 1 - June 2008 (Premiere Issue)

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