Immunotherapeutic strategies for the treatment of renal cell carcinoma: Where will we go?
Historically, renal cell carcinoma (RCC) is considered a chemotherapy-resistant tumor. The cornerstone of systemic therapy included mammalian target of rapamycin (mTOR) inhibitors, endothelial growth factor receptor (VEGFR) and tyrosine kinase inhibitors (TKIs). Currently, a new era is enteres with promising immunotherapeutic treatments, which are becoming commercially available. Areas covered: We provide a comprehensive review using PubMed and ClinicalTrials.gov about the following immunotherapies in RCC: i) vaccine therapy, ii) adoptive T Cell Transfer and CAR T cells, iii) nonspecific immunotherapy - IL-2 (new formulations), iv) Checkpoint inhibitors, v) other checkpoint-molecules. We will also discuss their mechanism of action and toxicity, the importance of developing new patient selection algorithms (immunoprofiling, guidelines updates) and new biomarkers such as PD-1 expression. Expert commentary: Immunotherapy shows promise, and the current tools used in clinical practice, including guidelines, staging-classification and algorithms should be revised and adapted to the new immunotherapeutic drugs. Although immunotherapy in RCC show promising results, more research is needed in parallel to discover biomarkers that enable the prediction of a treatment response and therefore lead to better patient selection.
a Department of Urology , Eberhard Karls University , Tuebingen , Germany.
Inês
I
Anselmo Da Costa
a Department of Urology , Eberhard Karls University , Tuebingen , Germany.
Steffen
S
Rausch
a Department of Urology , Eberhard Karls University , Tuebingen , Germany.
Stephan
S
Kruck
a Department of Urology , Eberhard Karls University , Tuebingen , Germany.
Tilman
T
Todenhöfer
a Department of Urology , Eberhard Karls University , Tuebingen , Germany.
Arnulf
A
Stenzl
a Department of Urology , Eberhard Karls University , Tuebingen , Germany.
Jens
J
Bedke
D000465:Algorithms; D014408:Biomarkers, Tumor / Q000378:metabolism; D019496:Cancer Vaccines / Q000008:administration & dosage / Q000276:immunology; D002292:Carcinoma, Renal Cell / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects / Q000379:methods*; D007680:Kidney Neoplasms / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D018579:Patient Selection
D014408:Biomarkers, Tumor; D019496:Cancer Vaccines
Renal cell carcinoma; atezolizumab; cabozantinib; checkpoint inhibitors; combination therapy; immunotherapy; nivolumab; pembrolizumab; programmed death receptor 1; tumor vaccine