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Antiangiogenic therapy combined with immune checkpoint blockade in renal cancer
Teele Kuusk1, Laurence Albiges2, Bernard Escudier2
1Department of Urology, The Netherlands Cancer Institute, Postbus 90203, 1006 BE, Amsterdam, The Netherlands.
Abstract:
Antiangiogenic therapy with vascular endothelial growth factor (VEGF) inhibitors is the current first-line treatment in metastatic renal cell carcinoma (mRCC). Immunotherapy with checkpoint inhibitor has been recently added to the armamentarium of mRCC treatment. These therapies are based on treatment with antibodies that block programmed cell death-1 (PD-1), programmed cell death ligand 1 (PD-L1) pathways, demonstrating impressive response rates and improved survival in several tumour types. So far, nivolumab is the only approved anti-PD-1 monoclonal antibody after VEGF therapy in mRCC. According to preclinical and clinical studies, combination therapies with VEGF- and checkpoint inhibitors have synergistic effect achieving improved response rates. However, toxicity in some combinations is high. In this article, we present a review of the ongoing trials with these drug combinations for RCC.
Insights
Vascular endothelial growth factor (VEGF) inhibitors and checkpoint inhibitors, like anti-PD-1 antibodies, show promise in treating metastatic renal cell carcinoma (mRCC). Combining these therapies may improve response rates in mRCC treatment.
Area of Science:
- Oncology
- Immunotherapy
- Medical research
Background:
- Metastatic renal cell carcinoma (mRCC) is currently treated with antiangiogenic therapy using vascular endothelial growth factor (VEGF) inhibitors.
- Immunotherapy, specifically checkpoint inhibitors targeting programmed cell death-1 (PD-1) and programmed cell death ligand 1 (PD-L1) pathways, is a new addition to mRCC treatment.
- Nivolumab is the only approved anti-PD-1 antibody for mRCC after VEGF therapy.
Purpose of the Study:
- To review ongoing clinical trials investigating combination therapies for renal cell carcinoma (RCC).
- To evaluate the synergistic effects and toxicity profiles of combining VEGF inhibitors and checkpoint inhibitors in RCC treatment.
Main Methods:
- Review of preclinical and clinical studies on combination therapies for mRCC.
- Analysis of ongoing clinical trials involving VEGF inhibitors and checkpoint inhibitors in RCC.
Main Results:
- Preclinical and clinical studies suggest synergistic effects between VEGF and checkpoint inhibitors, potentially improving response rates.
- Combination therapies may lead to improved response rates in mRCC.
- Some combinations of VEGF and checkpoint inhibitors exhibit high toxicity.
Conclusions:
- Combination therapies with VEGF and checkpoint inhibitors are being actively investigated for RCC treatment.
- While promising for improved response rates, the toxicity of these combinations requires careful consideration.
- Further research through ongoing trials is crucial to establish the optimal use of these combination therapies in mRCC.