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A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
Emerging monoclonal antibodies for the treatment of renal cell carcinoma (RCC)
Michael B Atkins1, George K Philips2
1a Department of Oncology , Georgetown-Lombardi Comprehensive Cancer Center , Washington , DC , USA.
Introduction:
Advanced renal cell carcinoma (RCC) was considered refractory to most cancer therapies until the 1980s, after which immune modulating agents and targeted agents were developed. Recently the rapid development of therapeutic monoclonal antibodies targeting immune checkpoint pathways has provided significant clinical benefit in patients with many distinct cancer types. Nivolumab, an anti-PD1 monoclonal antibody showed improvement in response rate and overall survival in patients with previously treated RCC and received US FDA approval in late 2015. Current efforts with anti-PD1-based therapy include combinations with ipilimumab and with VEGF pathway blockers in the hopes on building on the activity of single agent therapy.
Areas Covered:
We describe our current understanding of tumor immunology including the basis of the tumor-specific immune response and the adaptive mechanisms used by the tumor for immune escape. We describe the mechanisms of action as well as the therapeutic application of the antibodies, ipilimumab, nivolumab and atezolizumab in patients with RCC. We identify key areas of active research in biomarker development and combination therapies.
Expert Opinion:
Clinical trials and the field of RCC therapeutics are expected to move in the direction of combination therapies using immune checkpoint inhibitors, extending overall survival as a benchmark for new drug approvals, and biomarker validation for improved selection of patients for specific therapies.
Insights
Immune checkpoint inhibitors like nivolumab have improved outcomes for advanced renal cell carcinoma (RCC). Future RCC treatments will likely involve combination therapies and biomarkers to enhance patient selection and survival.
Area of Science:
- Oncology
- Immunology
- Pharmacology
Background:
- Advanced renal cell carcinoma (RCC) was historically resistant to treatments.
- The development of immune modulating and targeted agents, including monoclonal antibodies, has transformed RCC therapy.
- Nivolumab, an anti-PD1 antibody, demonstrated improved survival and response rates in previously treated RCC patients.
Purpose of the Study:
- To review current understanding of tumor immunology and immune escape mechanisms in RCC.
- To describe the mechanisms of action and therapeutic applications of ipilimumab, nivolumab, and atezolizumab in RCC.
- To identify key research areas in biomarker development and combination therapies for RCC.
Main Methods:
- Review of tumor immunology, including tumor-specific immune responses and immune escape.
- Description of mechanisms of action for ipilimumab, nivolumab, and atezolizumab.
- Analysis of current research in biomarker development and combination therapies for RCC.
Main Results:
- Immune checkpoint inhibitors have shown significant clinical benefit in advanced RCC.
- Combination therapies, such as anti-PD1 with ipilimumab or VEGF pathway blockers, are under investigation.
- Biomarker development is crucial for patient selection in RCC treatment.
Conclusions:
- Future RCC therapeutics will focus on combination therapies with immune checkpoint inhibitors.
- Overall survival will remain a key benchmark for new drug approvals in RCC.
- Biomarker validation is essential for optimizing patient selection for specific RCC therapies.
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