Facts and hopes for immunotherapy in renal cell carcinoma.

Immunotherapy has made a significant impact in many solid tumors, including renal cell carcinoma (RCC). RCC has been known to be immune responsive since the cytokine era of interferon-alfa and interleukin-2, but only a small number of patients had durable clinical benefit. Since then, discoveries of key tumor drivers, as well as an understanding of the contribution of angiogenesis and the tumor microenvironment (TME), has led to advances in drug development ultimately transforming patient outcomes. Combinations of anti-angiogenic agents with immune checkpoint inhibitors are now standard of care. Current challenges include patient selection for immunotherapy combinations, resistance acquisition and optimally sequencing therapies. Discoveries about RCC biology, the TME and resistance mechanisms will likely pave the way for the next generation of therapies.