Current Status and Future Directions of Immunotherapy in Renal Cell Carcinoma

Abstract

Purpose of review: Renal cell carcinoma (RCC) was recognized as an immunologically sensitive cancer over 30 years ago. The first therapies to affect the course of RCC were cytokines (interferon alfa-2B and interleukin-2). Subsequently, drugs that inhibit HIF (hypoxia-inducible factor)/VEGF (vascular endothelial growth factor) signaling demonstrated overall survival advantages (tyrosine kinase inhibitors and mTor inhibitors).

Recent findings: In the last 3 years, the immune checkpoint inhibitors (ICIs) have become the standard of care treatments in the first and second lines for RCC. Emerging data show that combinations of ICI, HIF signaling inhibitors, and cytokines are potentially powerful regimens. How to combine and sequence these types of therapies and how to integrate new approaches into the management of RCC are now the key questions for the field. Treatment of RCC is likely to change dramatically in the next few years.

Keywords: CTLA-4; Cytoreductive nephrectomy; Hypoxia-inducible factor; Immune checkpoint inhibitor; Interleukin-2; PD-1; PD-L1; Renal cell carcinoma; VEGF receptor; mTor inhibitor.