title: A novel personalized vaccine approach in combination with targeted therapy in advanced renal cell carcinoma.
abstract: The historical treatment paradigm for metastatic renal cell carcinoma has focused on immunomodulatory agents, such as IFN-α and IL-2, which provide good clinical outcomes in only a subset of patients. The development of therapies that target the VEGF and mTOR pathways have significantly altered the treatment landscape for this disease, with novel inhibitors providing substantial improvements in progression-free and overall survival over previous standards of care. Despite these advances, toxicity from targeted therapy and the development of resistance results in disease progression. By contrast, vaccine-based immunotherapy represents a promising new approach for the treatment of patients with metastatic renal cell carcinoma; however, tumor-induced immunosuppression has limited the clinical efficacy of this modality until recently. Some evidence suggests that certain targeted therapies, such as sunitinib, may reduce this immunosuppression and enhance the tumor microenvironment to promote synergy with autologous dendritic cell vaccines.
authors.affiliation: Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Saperstein Critical Care Tower 1S28, Los Angeles, CA 90048, USA. robert.figlin@cshs.org.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Figlin
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D000951:Antigens, Neoplasm / Q000276:immunology; D019496:Cancer Vaccines / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000276:immunology / Q000628:therapy*; D003131:Combined Modality Therapy; D003713:Dendritic Cells / Q000276:immunology* / Q000637:transplantation; D018274:Electroporation; D000068338:Everolimus; D006801:Humans; D016233:Immunotherapy, Active; D007211:Indoles / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000276:immunology / Q000628:therapy*; D058990:Molecular Targeted Therapy; D009363:Neoplasm Proteins / Q000037:antagonists & inhibitors / Q000502:physiology; D010671:Phenylurea Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D057285:Precision Medicine; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use; D011804:Quinolines / Q000008:administration & dosage / Q000627:therapeutic use; D012334:RNA, Neoplasm / Q000008:administration & dosage / Q000276:immunology; D015398:Signal Transduction / Q000187:drug effects; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077210:Sunitinib; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors; D059016:Tumor Microenvironment
chemical_list: D020533:Angiogenesis Inhibitors; D000951:Antigens, Neoplasm; D019496:Cancer Vaccines; D007211:Indoles; D009363:Neoplasm Proteins; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D011758:Pyrroles; D011804:Quinolines; D012334:RNA, Neoplasm; C553176:tivozanib; C401859:temsirolimus; D000068338:Everolimus; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases; D000077210:Sunitinib; D020123:Sirolimus