Immunotherapy Is Changing First-Line Treatment of Metastatic Renal-Cell Carcinoma.

Journal Article (Journal Article;Review)

The incidence of renal-cell carcinoma has been increasing each year, with nearly one third of new cases diagnosed at advanced or metastatic stage. The advent of targeted therapies for metastatic renal-cell carcinoma (mRCC) has underscored the need to subtype tumors according to tumor-immune expression profiles that may more reliably predict treatment outcomes. Over the past 2 decades, several vascular endothelial growth factor (VEGF) and tyrosine kinase inhibitors have been the mainstay for first- and second-line treatment of mRCC. Very recently, immunotherapy checkpoint inhibitors have significantly changed the treatment landscape for patients with mRCC, particularly for first-line treatment of intermediate to poor risk mRCC patients. Now, combination immunotherapy as well as combinations of immunotherapy with targeted agents can significantly alter disease outcomes. The field of immuno-oncology for mRCC has unveiled a deeper understanding of the immunoreactivity inherent to these tumors, and as a result combination therapy is evolving as a first-line modality. This review provides a timeline of advances and controversies in first-line treatment of mRCC, describes recent advances in understanding the immunoreactivity of these tumors, and addresses the future of combination anti-VEGF and immunotherapeutic platforms.

Full Text

Duke Authors

Cited Authors

  • Labriola, MK; Batich, KA; Zhu, J; McNamara, MA; Harrison, MR; Armstrong, AJ; George, DJ; Zhang, T

Published Date

  • June 2019

Published In

Volume / Issue

  • 17 / 3

Start / End Page

  • e513 - e521

PubMed ID

  • 30858035

Pubmed Central ID

  • PMC7004481

Electronic International Standard Serial Number (EISSN)

  • 1938-0682

Digital Object Identifier (DOI)

  • 10.1016/j.clgc.2019.01.017

Language

  • eng

Conference Location

  • United States