Update on immunotherapy for renal cancer

Area of Science:

• Oncology
• Immunology
• Nephrology

Background:

• Immune checkpoint inhibitors (ICIs) have revolutionized advanced renal cell carcinoma (RCC) treatment.
• Nivolumab (anti-PD-1) and ipilimumab (anti-CTLA-4) combinations are approved for previously untreated patients.
• Pembrolizumab (anti-PD-1) and avelumab (anti-PD-L1) combinations with axitinib (TKI) are approved for all risk groups.

Purpose of the Study:

• To provide a historical overview of immuno-oncology in RCC.
• To detail the mechanisms of action of ICIs in RCC.
• To review current evidence on ICI regimens, adverse effects, and patient selection in RCC.

Main Methods:

• Literature review of clinical trials and studies on ICIs in RCC.
• Analysis of mechanisms of action for PD-1, PD-L1, and CTLA-4 inhibitors.
• Discussion of safety profiles and patient selection strategies for immunotherapy.

Main Results:

• ICIs have demonstrated significant efficacy in advanced RCC across various regimens.
• Combination therapies show improved outcomes in intermediate- and poor-risk patients.
• Adverse events associated with ICIs require careful management and patient monitoring.

Conclusions:

• ICIs represent a major advancement in advanced RCC treatment.
• Individualized therapy through appropriate patient selection is crucial for optimizing outcomes.
• Future research directions include novel ICI combinations and biomarkers for treatment response.