Immunotherapy: incorporation in the evolving paradigm of renal cancer management and future prospects

Abstract

Significant progress has been made in the management of renal cell carcinoma (RCC) during the last few decades. In early stage, localized disease, surgical resection remains the modality of choice, with no therapeutic interventions as options for post-operative therapy other than simple observation and clinical surveillance. However, treatment options in the advanced or metastatic setting are increasing at a dizzying pace, initially with cytokine therapy, then with the increased availability of targeted therapy including novel small-molecule inhibitors of receptor tyrosine kinases and monoclonal antibodies targeting novel proteins, establishing them as the current standard of care. Even more recently, immunotherapy has seen tremendous development in the form of immune checkpoint inhibition and vaccines. Overall, these interventions have gradually changed the landscape of cancer management in general, and metastatic renal cell carcinoma (mRCC) in particular. This is exemplified by the recent United States Food and Drug Administration (USFDA) approval of nivolumab for patients with mRCC after failure of TKI therapy. In this review, we present a brief overview of the current management of mRCC, primarily the clear cell subtype (ccRCC), and discuss the major clinical trials and data on the immunotherapy in advanced or mRCC.

A Downmodulated MicroRNA Profiling in Patients with Gastric Cancer

“…miR-19b is fully evidenced in literature as a tumor oncogene in various types of cancers, and the underlying mechanisms are investigated accordingly [52–55]. It is also considered a novel potential biomarker to indicate progression of GC [23].…”

Renal cell carcinoma drug and cell therapy: today and tomorrow

“…Diarrhoea and colitis are also common side effects, which are more often encountered in anti-CTLA-4-antibodies therapy. Hepatotoxicity and endocrinopathy are possible (Liu et al 2017). Different inhibitors in RCC, which are being clinically tested, are described in Table 1.…”

“…Vaccines are used for treating a primary tumour, but not for preventing an onco- Table 1. Immune drugs in RCC are currently being clinically tested (Liu et al 2017 logical disease. Clinical trials are conducted to assess the effectiveness of different vaccines, but none has so far demonstrated an increase in the survivability rate.…”

Immune Checkpoint Inhibitors in Gynecological Cancers: Update of Literature and Perspectives of Clinical Research

“…pembro-lizumab and nivolumab) and PD-L1 (i.e. avelumab, atezolizumab and durvalumab), as well as mAbs targeting CTLA-4 (ipilimumab and tremelimumab), have been approved by Food and Drug Administration (FDA) for several malignancies, such as melanoma, non-small cell lung cancer, renal cell cancer, urothelial cancer and lymphoma (16)(17)(18)(19)(20). Anti-CTLA mAbs and anti-PD-1/PD-L1 mAbs cause immune-related adverse events (AEs) in 60% and 40% of cases, respectively, but severe AEs are more frequent with anti-CTLA therapy (21,22).…”