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Updated: Jun 10, 2026

A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
Targeted treatment for metastatic renal cell carcinoma and immune regulation
K A Laschos1, K T Papazisis, L F Kontovinis
1Applied Molecular Oncology Laboratory, Theagenion Cancer Hospital, 2, Alexandrou Simeonidi Str, 540 07 Thessaloniki, Greece. konstantinos.laschos@gmail.com
Abstract:
New targeted agents have become the mainstream of treatment in metastatic renal cell carcinoma (mRCC) and substituted the previous cytokine-based therapies. Vascular endothelial growth factor (VEGF) pathway is the principle target for drugs like sunitinib, sorafenib and bevacizumab. As VEGF is regulating dendritic cell (DC) function, inhibition of VEGF results in activation of DCs and a shift towards cellular (type 1) immunity, which is believed to favor cancer rejection. Recent studies have established the immune-stimulating effects of sunitinib that may as well be a marker for effectiveness. On the other hand, sorafenib not only inhibits VEGF receptor (VEGFR) but is also a B-Raf inhibitor (a component of the ras - MAPK pathway) and this leads to downregulation of immune responses. Sorafenib has not yet shown benefit in first-line treatment of mRCC when compared to interferon (IFN)-alpha and sorafenib-mediated immunosuppression may partially account for that. Mammalian target of rapamycin (mTOR), the target of temsirolimus, is an element of the DC activation pathway. There are no data for in vivo effects of temsirolimus in the immune system. The addition of IFN-alpha to temsirolimus resulted in inferior outcomes than temsirolimus alone. IFN-alpha has however still a place in mRCC treatment, as bevacizumab has been approved in combination with IFN-alpha. New clinical trials address the effects of the combination of cytokines with targeted agents. The immune-modulating effects of targeted treatments may be important in pharmacodynamic outcomes, effectiveness or the development of adverse events.
Insights
Targeted therapies are now standard for metastatic renal cell carcinoma (mRCC), shifting from cytokine treatments. Some agents like sunitinib boost immune responses, potentially improving effectiveness in mRCC treatment.
Area of Science:
- Oncology
- Immunology
- Pharmacology
Background:
- Metastatic renal cell carcinoma (mRCC) treatment has shifted from cytokine-based therapies to targeted agents.
- Vascular Endothelial Growth Factor (VEGF) pathway is a primary target for mRCC drugs, influencing dendritic cell (DC) function and immune responses.
- Understanding the immunomodulatory effects of targeted agents is crucial for optimizing mRCC treatment strategies.
Purpose of the Study:
- To review the immunomodulatory effects of targeted agents used in metastatic renal cell carcinoma (mRCC).
- To compare the immune effects of different targeted agents, including sunitinib, sorafenib, and temsirolimus.
- To discuss the potential role of immune-modulating effects in the efficacy and adverse events of mRCC therapies.
Main Methods:
- Literature review of targeted agents and their effects on the immune system in mRCC.
- Analysis of drug mechanisms, including VEGF inhibition, B-Raf inhibition, and mTOR targeting.
- Discussion of clinical trial data and immune responses in mRCC patients.
Main Results:
- VEGF inhibitors like sunitinib can activate dendritic cells and promote cellular immunity, potentially enhancing cancer rejection.
- Sorafenib, a VEGFR and B-Raf inhibitor, may downregulate immune responses, possibly explaining its limited benefit in first-line mRCC treatment.
- Temsirolimus targets mTOR, a component of DC activation, but its in vivo immune effects require further investigation. Combination therapies involving cytokines and targeted agents are under clinical investigation.
Conclusions:
- Targeted agents in mRCC have significant immunomodulatory effects that can influence treatment outcomes.
- The immune-stimulating effects of agents like sunitinib may correlate with effectiveness.
- Further research into the immune-modulating properties of targeted therapies is essential for advancing mRCC treatment and managing adverse events.
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