A review.The article is a review of the study and results by McDermott DF et al. (2005) entitled "Randomized Phase III trial of high-dose interleukin-2 vs. s.c. interleukin-2 and interferon in patients with metastatic renal cell carcinoma.".A commentary by Johannes Vieweg, Associate Professor in the Departments of Urol. and Immunol. at Duke University Medical Center, Durham, North Carolina is provided.A randomized phase III trial of 193 patients with progressive metastatic renal cell carcinoma (RCC) showed that high-dose i.v. bolus interleukin-2 (HDIB IL-2) demonstrated a superior response rate and more durable complete response rate than IL-2 plus interferon-α2b.Patients with liver or bone metastases or primary tumor in place had improved response rates and survival with HDIB IL-2, relative to lower-dose IL-2 and interferon-α2b.This study, however, failed to demonstrate an improvement in patient survival, probably because only few patients benefited from such treatment.The Cytokine Working Group study confirms that, for patients with good performance status, HDIB IL-2 should remain the preferred therapy for patient with metastatic RCC.Such treatment will still require referral to specialized centers with the necessary skills and equipment.Applicability of high-dose IL-2 remains limited.Fortunately, newer compounds that target tyrosine receptor kinases or angiogenic pathways seem quite promising in the treatment of metastatic RCC and, if proven effective, may supplant IL-2 in the foreseeable future.