[Immunotherapy for renal cell carcinoma - current status].

Area of Science:

• Oncology
• Immunotherapy
• Renal Cell Carcinoma

Background:

• Metastatic renal cell carcinoma (mRCC) treatment has evolved with immune-checkpoint inhibitors like Nivolumab and multikinase inhibitors.
• Nivolumab and Cabozantinib are recommended as second-line treatments in Germany post-VEGF therapy.
• Previous trials established Nivolumab's efficacy in overall survival and response rates compared to Everolimus.

Purpose of the Study:

• To evaluate the efficacy and safety of Nivolumab and Nivolumab plus Ipilimumab in mRCC treatment.
• To compare combination immunotherapies with existing treatments like Sunitinib and Everolimus.
• To assess the role of PD-1/PD-L1 inhibitors in combination with other agents for mRCC.

Main Methods:

• Analysis of data from CheckMate 025 and CheckMate 214 randomized trials.
• Comparison of Nivolumab versus Everolimus for second-line mRCC treatment.
• Evaluation of Nivolumab plus Ipilimumab versus Sunitinib as first-line therapy for mRCC.

Main Results:

• Nivolumab demonstrated improved overall survival and response rates versus Everolimus.
• The combination of Nivolumab and Ipilimumab showed significantly higher objective response rates and overall survival compared to Sunitinib in intermediate and high-risk patients.
• The combination therapy also offered a better side effect profile and quality of life than Sunitinib, despite increased immune-related adverse events.

Conclusions:

• Nivolumab remains a standard second-line treatment for mRCC after VEGF therapy.
• Nivolumab in combination with Ipilimumab is a promising first-line option for intermediate and high-risk mRCC patients.
• Further research is needed on PD-1/PD-L1 inhibitors combined with Bevacizumab and VEGFR-TKIs, focusing on overall survival and safety.