The emerging landscape of neo/adjuvant immunotherapy in renal cell carcinoma

Pooya Dibajnia1, Luisa M Cardenas1, Aly-Khan A Lalani1

  • 1Department of Oncology, Juravinski Cancer Centre, McMaster University, Hamilton, ON , Canada.

Insights

Adjuvant and neoadjuvant therapies for renal cell carcinoma (RCC) are under investigation. While some immune checkpoint inhibitors show promise, more data is needed to confirm survival benefits in early-stage disease.

Area of Science:

  • Oncology
  • Nephrology
  • Immunotherapy

Background:

  • Adjuvant and neoadjuvant therapies for renal cell carcinoma (RCC) are critical for reducing recurrence risk, representing an unmet clinical need.
  • Recent advancements in metastatic RCC have involved PD-1/PD-L1 immune checkpoint inhibitors (ICIs).
  • Investigating ICIs in early-stage RCC (adjuvant and neoadjuvant settings) aims to determine their clinical benefit in disease trajectory.

Approach:

  • Reviewing current adjuvant/neoadjuvant therapies for RCC.
  • Analyzing the efficacy of immune checkpoint inhibitors (ICIs) in early-stage RCC.
  • Highlighting ongoing research and future opportunities, including combinations of ICIs with targeted therapies and vaccines.

Key Points:

  • Pembrolizumab has demonstrated a disease-free survival benefit in the adjuvant setting for RCC.
  • Results from other ICI studies in the adjuvant/neoadjuvant settings have not yet shown significant benefits.
  • Mature survival data is required to establish the overall survival benefit of ICIs in the curative-intent setting for RCC.

Conclusions:

  • Immune checkpoint inhibitors (ICIs) represent a promising avenue for adjuvant and neoadjuvant therapy in renal cell carcinoma (RCC).
  • Further research and mature data are essential to confirm the long-term efficacy and survival benefits of ICIs in early-stage RCC.
  • Combination strategies involving ICIs with other therapeutic agents are emerging and warrant further investigation.

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