**4. Tumor vaccines**

Autologous irradiated tumor cells mixed with bacillus Calmette-Guérin (BCG) were tested in two randomized trials and did not result in prolonged DFS [38–40].

Similarly, autologous, tumor-derived heat-shock protein (glycoprotein 96)-peptide complex (HSPPC-96; vitespen) did not result in a statistically significant improvement of DFS [41].

A trial with an autologous renal tumor cell vaccine only reported improved DFS in the vaccine group [42], but the number of patients lost after the randomization step, the imbalance of this loss, and the absence of tabulation of OS led to criticism of the results [43].

This therapy has not been implemented in routine clinical practice.
