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Immunotherapy: incorporation in the evolving paradigm of renal cancer management and future prospects
Liu KG, Gupta S, Goel S
Significant progress has been made in the management of renal cell carcinoma (RCC) during the last few decades. In early stage, localized disease, surgical resection remains the modality of choice, with no therapeutic interventions as options for post-operative therapy other than simple observation and clinical surveillance. However, treatment options in the advanced or metastatic setting are increasing at a dizzying pace, initially with cytokine therapy, then with the increased availability of targeted therapy including novel small-molecule inhibitors of receptor tyrosine kinases and monoclonal antibodies targeting novel proteins, establishing them as the current standard of care. Even more recently, immunotherapy has seen tremendous development in the form of immune checkpoint inhibition and vaccines. Overall, these interventions have gradually changed the landscape of cancer management in general, and metastatic renal cell carcinoma (mRCC) in particular. This is exemplified by the recent United States Food and Drug Administration (USFDA) approval of nivolumab for patients with mRCC after failure of TKI therapy. In this review, we present a brief overview of the current management of mRCC, primarily the clear cell subtype (ccRCC), and discuss the major clinical trials and data on the immunotherapy in advanced or mRCC.
KEYWORDS: checkpoint Inhibition; cytokines; immunotherapy; renal cell carcinoma; vaccines
Editorial comment from Piotr Chlosta:
In this review, the authors highlight the entire field of clinical development of immune based therapy for mRCC, and hope that the reader will find this piece of work useful as a summary and as a source of reference, whilst recognising it is a highly dynamic and evolving field