Clearing up Clear Cell: Clarifying the Immuno-Oncology Treatment Landscape for Metastatic Clear Cell RCC

Abstract

Patients with advanced or malignant renal cell carcinoma at the time of diagnosis have historically had a poor prognosis. Immunonologic agents have significantly altered the therapeutic landscape and clinical outcomes of these patients. In this review, we highlight recent and upcoming clinical trials investigating the role of immunotherapies in clear cell RCC. In particular, we emphasize immunotherapy-based combinations, including immune checkpoint inhibitor (ICI) combinations, neoadjuvant, and adjuvant ICI, and ICI agents combined with anti-VEGF therapy.

Renal Cell Carcinoma with Cardiac Metastases: A Case Report and Review of the Literature

“…While metastasectomy may be an option for some patients with an isolated cardiac metastasis, surgical resection is more often not possible due to tumor location or co-morbid conditions (10,16,18,23). Combination immunotherapy with monoclonal antibodies directed against programmed death 1 (PD-1) such as nivolumab and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) such as ipilimumab have become an integral part of managing metastatic RCC (6,8,24,25). However, these agents have not been tested in patients with cardiac metastases (16,26).…”

The roaring 2020s: a new decade of systemic therapy for renal cell carcinoma

“…In the past 2 decades targeted therapies and immune checkpoint inhibitors (ICI) have become the new pillars of RCC systemic therapy, a departure from high-dose cytokines, such as IL-2 and IFN-a [4][5][6]. More specifically, inhibitors of angiogenesis with targets along the vascular endothelial grow factor (VEGF)/hypoxia inducible factor (HIF) pathway have offered encouraging response rates and outcomes in recent trials [7,8].…”

Role of metastasectomy in the management of renal cell carcinoma

“…While localized RCC can be removed surgically, up to 17% of cases are metastatic at the time of diagnosis. Furthermore, 20%-40% of patients with localized disease who initially undergo extirpative surgical treatment will eventually develop distant metastasis (2). Systemic therapy is the mainstay of treatment in advanced renal cancer and options have expanded to include a range of new drugs and combination therapies (Table 1) (3)(4)(5)(6)(7)(8).…”