RATIONALE: Interferon alfa may interfere with the growth of tumor cells. Interleukin-2 may stimulate a person's white blood cells to kill tumor cells. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining interferon alfa with interleukin-2 and fluorouracil may kill more tumor cells. It is not yet known whether interferon alfa is more effective with or without interleukin-2 and fluorouracil in treating metastatic kidney cancer. PURPOSE: Randomized phase III trial to compare the effectiveness of interferon alfa combined with interleukin-2 and fluorouracil to that of interferon alfa alone in treating patients who have advanced metastatic kidney cancer.
OBJECTIVES: * Compare progression-free and overall survival of patients with advanced metastatic renal carcinoma treated with interferon alfa with or without interleukin-2 and fluorouracil. * Compare the toxicity of these regimens in these patients. * Assess the quality of life of patients treated with these regimens. OUTLINE: This is a randomized, open-label, multicenter study. Patients are randomized to 1 of 2 treatment arms. * Arm I (Interferon alfa monotherapy): Patients receive interferon alfa subcutaneously (SC) on days 1, 3, and 5. Treatment continues weekly for at least 9 weeks in the absence of disease progression or unacceptable toxicity. * Arm II (Interferon alfa, interleukin-2, and fluorouracil combination therapy): Patients receive interferon alfa SC on day 1 of weeks 1 and 4 and days 1, 3, and 5 of weeks 2, 3, 5, 6, 7, and 8. Patients also receive interleukin-2 SC twice daily on days 3-5 of weeks 1 and 4 and once daily on days 1, 3, and 5 of weeks 2 and 3. Patients then receive fluorouracil IV on day 1 of weeks 5-8. Treatment repeats every 10 weeks for up to 2 courses in the absence of disease progression or unacceptable toxicity. Quality of life is assessed at baseline, at 9, 19, and 26 weeks, and then at 8 months. Patients are followed at 8, 10, and 12 months, every 4 months for 1 year, and then every 6 months thereafter. PROJECTED ACCRUAL: A total of 670 patients (335 per treatment arm) will be accrued for this study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
670
Onze Lieve Vrouw Ziekenhuis Aalst
Aalst, Belgium
Institut Jules Bordet
Brussels, Belgium
Academisch Ziekenhuis der Vrije Universiteit Brussel
Brussels, Belgium
Universitair Ziekenhuis Antwerpen
Edegem, Belgium
U.Z. Gasthuisberg
Leuven, Belgium
Klinikum Kassel
Kassel, Germany
Leiden University Medical Center
Leiden, Netherlands
Academisch Ziekenhuis Maastricht
Maastricht, Netherlands
Universitair Medisch Centrum St. Radboud - Nijmegen
Nijmegen, Netherlands
University Medical Center Rotterdam at Erasmus Medical Center
Rotterdam, Netherlands
...and 2 more locations
Survival
Time to progression as measured by RECIST criteria
Comparison of toxicity levels (Grade III and IV)
Comparison of quality of life before, during, after completion of study treatment
Impact of the treatment regimens on health economics
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