title: Immuno-oncology for renal cell carcinoma treatment: future perspectives for combinations and sequences with molecularly targeted agents.
abstract: From a theoretical viewpoint, combining molecularly targeted agents endowed with antiangiogenic properties with immunotherapy makes sense in treatment of metastatic renal cell carcinoma (RCC); this neoplasm is highly angiogenesis-dependent, as well as potentially immunogenic. Areas covered: The authors performed a literature search looking for clinical trials aimed at evaluating efficacy and tolerability of combinations (or sequences) of molecularly targeted agents and different immunotherapeutic approaches in metastatic RCC. Expert opinion: Combinations of molecularly targeted agents with old immunotherapeutics (i.e., cytokines) seem to add little to the presently available treatment standards (mainly monotherapy with targeted agents). Newer combinations with immune checkpoint inhibitors are promising but cumulative toxicity is an important issue, although highly dependent on the different companion drugs. Combinations with vaccines are ongoing, but first available data are not encouraging. A more thorough comprehension of the complex effects of these combinations on the immune system is mandatory to develop less empiric treatments.
authors.affiliation: a Medical Oncology , I.R.C.C.S. San Matteo University Hospital Foundation , Pavia , Italy.|b Italian Group of Onco-Nephrology/Gruppo Italiano di Onco-Nefrologia (G.I.O.N.) , Pavia , Italy.
authors.forename: Camillo
authors.initials: C
authors.lastname: Porta
authors.affiliation: a Medical Oncology , I.R.C.C.S. San Matteo University Hospital Foundation , Pavia , Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Toscani
authors.affiliation: c Department of Oncology , Military Institute of Medicine , Warsaw , Poland.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Czarnecka
authors.affiliation: c Department of Oncology , Military Institute of Medicine , Warsaw , Poland.
authors.forename: Cezary A
authors.initials: CA
authors.lastname: Szczylik
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000276:immunology; D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000276:immunology; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000276:immunology; D016503:Drug Delivery Systems / Q000379:methods*; D005544:Forecasting; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000276:immunology; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents
keywords: Checkpoint inhibitors; combinations; cytokines; immunotherapy; molecularly targeted agents; vaccines