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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
Integrating Immunotherapy Into the Management of Renal Cell Carcinoma
Matthew Zibelman1, Elizabeth R Plimack1
1From Department of Hematology/Oncology, Fox Chase Cancer Center, and Temple Health, Philadelphia, Pennsylvania.
Abstract:
Before 2005, systemic treatment of metastatic renal cell carcinoma (RCC) was limited to a few minimally effective options. Since then, new agents have emerged targeting the vascular endothelial growth factor and mTOR pathways, which has improved outcomes for patients. Options increased even further beginning in 2015 with 3 new agents, including the addition of nivolumab, the first immune checkpoint inhibitor to demonstrate improved survival in RCC. RCC has long been considered a malignancy with immunogenic potential, and nivolumab offers the potential for durable responses in some patients with a generally tolerable toxicity profile. With so many drugs available to clinicians and patients, properly integrating immune checkpoint blockade (ICB) into the treatment paradigm is challenging. Additionally, emerging research with other ICB agents, as well as ongoing trials of combination strategies, is likely to further impact clinical decision-making. This article attempts to provide some context to inform systemic treatment decisions in the current landscape, with a particular emphasis on the role of immunotherapy, outlines the ongoing immunotherapy research in RCC, and discusses how treatment may evolve.
Insights
Systemic treatment for metastatic renal cell carcinoma (RCC) has advanced significantly, particularly with the introduction of immunotherapy like nivolumab. Integrating immune checkpoint blockade (ICB) is now crucial for improving patient outcomes.
Area of Science:
- Oncology
- Immunotherapy
- Renal Cell Carcinoma Research
Background:
- Systemic treatment for metastatic renal cell carcinoma (RCC) before 2005 offered limited efficacy.
- Advancements targeting vascular endothelial growth factor and mTOR pathways improved patient outcomes since 2005.
- The introduction of nivolumab in 2015 marked a significant shift, being the first immune checkpoint inhibitor to improve survival in RCC.
Purpose of the Study:
- To provide context for systemic treatment decisions in metastatic RCC.
- To emphasize the role and integration of immunotherapy in current RCC treatment paradigms.
- To outline ongoing immunotherapy research and discuss the future evolution of RCC treatment.
Main Methods:
- Review of systemic agents targeting VEGF and mTOR pathways.
- Analysis of the impact of immune checkpoint inhibitors (ICIs), specifically nivolumab.
- Discussion of emerging ICI research and combination strategies in clinical trials.
Main Results:
- New agents targeting VEGF and mTOR pathways have improved outcomes.
- Nivolumab demonstrated improved survival, offering durable responses with tolerable toxicity.
- The increasing number of treatment options presents challenges in clinical decision-making.
Conclusions:
- Immune checkpoint blockade (ICB) represents a major advancement in metastatic RCC treatment.
- Effective integration of ICB into the treatment paradigm is essential.
- Ongoing research and combination strategies will continue to shape future treatment approaches for RCC.
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