Sebastiano Nazzani1,2, Amélie Bazinet1,3, Pierre I Karakiewicz1,3. 1. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Québec, Canada. 2. Academic Department of Urology, IRCCS Policlinico San Donato, University of Milan, Milan, Italy. 3. Department of Urology, Université da Montréal, Montreal, Québec, Canada.
Abstract
PURPOSE OF REVIEW: To summarize current knowledge on promising immunotherapeutic agents and to provide a brief outline of current use of immunotherapeutic agents in patients with locally advanced or metastatic renal cell carcinoma (RCC). RECENT FINDINGS: Immunotherapy with mAbs directed against programed death cell protein 1, programed death-ligand 1 (PD-L1) and cytotoxic T-Lymphocyte Antigen 4 has become new first-line standard of care for moderate and poor-risk metastatic RCC patients. Similarly, the combination immune-oncology treatment and vascular endothelial growth factor (VEGF) mAbs also showed promising results in first-line therapy despite relative data immaturity. Finally, immune-oncology monotherapy (nivolumab) already represents second or third-line standard of care after tyrosine kinase inhibitor failure. SUMMARY: Combination immune-oncology therapy represents the standard of care for management of intermediate-to-poor risk clear cell metastatic RCC. In addition, combination of immune-oncology and anti-VEGF antibody represents a treatment option across all risk levels in patient with elevated PD-L1 expression. Finally, nivolumab is one of two ideal treatment options in second-line clear cell metastatic RCC patients.
PURPOSE OF REVIEW: To summarize current knowledge on promising immunotherapeutic agents and to provide a brief outline of current use of immunotherapeutic agents in patients with locally advanced or metastatic renal cell carcinoma (RCC). RECENT FINDINGS: Immunotherapy with mAbs directed against programed death cell protein 1, programed death-ligand 1 (PD-L1) and cytotoxic T-Lymphocyte Antigen 4 has become new first-line standard of care for moderate and poor-risk metastatic RCCpatients. Similarly, the combination immune-oncology treatment and vascular endothelial growth factor (VEGF) mAbs also showed promising results in first-line therapy despite relative data immaturity. Finally, immune-oncology monotherapy (nivolumab) already represents second or third-line standard of care after tyrosine kinase inhibitor failure. SUMMARY: Combination immune-oncology therapy represents the standard of care for management of intermediate-to-poor risk clear cell metastatic RCC. In addition, combination of immune-oncology and anti-VEGF antibody represents a treatment option across all risk levels in patient with elevated PD-L1 expression. Finally, nivolumab is one of two ideal treatment options in second-line clear cell metastatic RCCpatients.