TY - JOUR
T1 - Immunotherapy Is Changing First-Line Treatment of Metastatic Renal-Cell Carcinoma
AU - Labriola, Matthew K.
AU - Batich, Kristen A.
AU - Zhu, Jason
AU - McNamara, Megan A.
AU - Harrison, Michael R.
AU - Armstrong, Andrew J.
AU - George, Daniel J.
AU - Zhang, Tian
N1 - Funding Information:
A.J.A. has received funding (to Duke) from Medivation/Astellas, Bayer, Dendreon, Janssen, Active Biotech, Sanofi-Aventis, Gilead, Novartis, and Pfizer; consulting/speaking with Dendreon and Sanofi Aventis; and consulting with Medivation/Astellas and Janssen. D.J.G. has received research funding (to Duke) from Acerta, Astellas, Bayer, Bristol-Myers Squibb, Dendreon, Exelixis, Innocrin, Janssen, Novartis, Pfizer; consulting and speaking with Bayer, Exelixis, Sanofi; and consulting with Astellas, AstraZeneca, Bristol-Myers Squibb, Innocrin, Janssen, Merck, Myovant, Pfizer. T.Z. has received research funding (to Duke) from Pfizer, Janssen, Acerta, Abbvie, Novartis, Merrimack, OmniSeq, PGDx, and Merck; consulting/speaking with Genentech Roche and Exelixis; consulting with AstraZeneca, Amgen, Pharmacyclics, BMS, Pfizer, Foundation Medicine, Janssen, Bayer, and Sanofi Aventis; and stock ownership/employment (spouse) from Capio Biosciences. M.M. has received research funding (to Duke) from Janssen, Agensys, Bayer, Seattle Genetics, and Clovis. The other authors have stated that they have no conflict of interest.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/6
Y1 - 2019/6
N2 - 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.
AB - 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.
KW - Immune checkpoint inhibitors
KW - Metastatic renal-cell carcioma
KW - Targeted therapies
KW - VEGF therapies
KW - VEGF-immunotherapy combinations
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U2 - 10.1016/j.clgc.2019.01.017
DO - 10.1016/j.clgc.2019.01.017
M3 - Review article
C2 - 30858035
AN - SCOPUS:85062672657
SN - 1558-7673
VL - 17
SP - e513-e521
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
IS - 3
ER -