title: Immunotherapy: incorporation in the evolving paradigm of renal cancer management and future prospects.
abstract: 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.
authors.affiliation: Department of Medical Oncology, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Kenneth G
authors.initials: KG
authors.lastname: Liu
authors.affiliation: Department of Internal Medicine, St. Barnabas Hospital, Bronx, NY, USA.
authors.forename: Sorab
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Medical Oncology, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Goel
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D019496:Cancer Vaccines / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000628:therapy*; D005544:Forecasting; D006801:Humans; D007167:Immunotherapy / Q000379:methods* / Q000639:trends; D007680:Kidney Neoplasms / Q000473:pathology / Q000628:therapy*; D058990:Molecular Targeted Therapy / Q000379:methods / Q000639:trends; D009362:Neoplasm Metastasis; D014611:Vaccination / Q000379:methods / Q000639:trends
chemical_list: D000970:Antineoplastic Agents; D019496:Cancer Vaccines
keywords: checkpoint Inhibition; cytokines; immunotherapy; renal cell carcinoma; vaccines