Cure in Advanced Renal Cell Cancer: Is It an Achievable Goal?

Area of Science:

• Oncology
• Immunology

Background:

• Metastatic renal cell cancer (mRCC) is often chemoresistant, with low spontaneous remission rates.
• Checkpoint inhibitors (e.g., anti-PD-1 antibodies) offer durable responses in solid tumors but require host T cells and tumor antigens.
• Combination therapy is being explored to enhance response rates to immunotherapy in mRCC.

Purpose of the Study:

• To report on three mRCC patients treated with combination immunotherapy.
• To conduct a literature review on combination immunotherapy for mRCC.
• To discuss future directions for combination immunotherapy in mRCC.

Main Methods:

• Case series of three mRCC patients treated with anti-PD-1 antibody therapy combined with bevacizumab, ipilimumab, or radiotherapy.
• Comprehensive literature review on combination immunotherapy for mRCC.

Main Results:

• Two patients achieved complete clinical response within three months of treatment.
• The third patient showed a significant response to radiotherapy outside the initial treatment field, lasting over 12 months.
• Combination therapy demonstrated potential for complete responses and improved survival in mRCC.

Conclusions:

• Immunotherapy combined with other treatments can induce complete responses in mRCC, even with bulky disease.
• Combination immunotherapy appears to yield more durable responses in mRCC compared to monotherapy.
• Further research on dosing, sequencing, biomarkers, and longer follow-up is needed to establish cure potential.