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Role of immunotherapy in kidney cancer

Sebastiano Nazzani1,2, Amélie Bazinet1,3, Pierre I Karakiewicz1,3

  • 1Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Québec, Canada.

Current Opinion in Supportive and Palliative Care
|July 27, 2018
PubMed
Abstract

Insights

Immunotherapy, including immune-oncology treatments and vascular endothelial growth factor (VEGF) monoclonal antibodies (mAbs), is now standard care for advanced renal cell carcinoma (RCC). Nivolumab is a key option for second-line treatment after other therapies fail.

Area of Science:

  • Oncology
  • Immunotherapy
  • Renal Cell Carcinoma Research

Background:

  • Metastatic renal cell carcinoma (RCC) treatment has evolved significantly.
  • Immunotherapy has emerged as a critical modality in managing advanced RCC.

Purpose of the Study:

  • To review current knowledge on immunotherapeutic agents for advanced or metastatic RCC.
  • To outline the current application of these agents in RCC patient care.

Main Methods:

  • Review of current literature on immunotherapeutic agents in RCC.
  • Analysis of clinical data for immune-oncology treatments and VEGF inhibitors.

Main Results:

  • Immune-oncology agents targeting PD-1/PD-L1 and CTLA-4 are now first-line standards for moderate/poor-risk metastatic RCC.
  • Combination therapies (immune-oncology plus VEGF mAbs) show promise in first-line settings.
  • Immune-oncology monotherapy (nivolumab) is a standard second or third-line option post-tyrosine kinase inhibitor failure.

Conclusions:

  • Combination immune-oncology therapy is the standard for intermediate-to-poor risk clear cell metastatic RCC.
  • Immune-oncology plus anti-VEGF antibody therapy is an option for patients with high PD-L1 expression across risk levels.
  • Nivolumab is a primary choice for second-line treatment in clear cell metastatic RCC.

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