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

Matthew K. Labriola, Kristen A. Batich, Jason Zhu, Megan A. McNamara, Michael R. Harrison, Andrew J. Armstrong, Daniel J. George, Tian Zhang

Research output: Contribution to journalReview articlepeer-review

20 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)e513-e521
JournalClinical Genitourinary Cancer
Volume17
Issue number3
DOIs
StatePublished - Jun 2019
Externally publishedYes

Keywords

  • Immune checkpoint inhibitors
  • Metastatic renal-cell carcioma
  • Targeted therapies
  • VEGF therapies
  • VEGF-immunotherapy combinations

ASJC Scopus subject areas

  • Oncology
  • Urology

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