The treatment of advanced renal cell carcinoma is a continuing problem because of the lack of effective systenic therapy. A review of recent clinical trials of various chemotherapeutic agents reveals vinblastine, CCNU, and Methyl GAG to be the most effective of all agents tested. This efficacy however, is in the modest range of 15% partial response. Somewhat increased efficacy is seen in combination regimens containing vinblastine. Hormonal therapy with progestins and androgens is widely used because of their slight efficacy, lack of toxicity, and the psychological benefit of doing something. It should be considered, when judging the efficacy of any systemic therapy used in this disease, that the patients with minimal pulmonary disease always fair the best.
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