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Immunotherapy for kidney cancer

status quo and the future

Bedke, Jensa; Stühler, Viktoriaa; Stenzl, Arnulfa; Brehmer, Bernhardb

doi: 10.1097/MOU.0000000000000466
IMMUNOTHERAPY FOR UROLOGIC CANCERS: Edited by Shahrokh F. Shariat and Jens Bedke
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Purpose of review The treatment landscape in advanced and metastatic renal cell carcinoma (RCC) is moving from the inhibition of tyrosine kinases (TKI) and the mammalian target of rapamycin (mTOR) inhibitors to specific immunooncology agents like immune checkpoint inhibitors (ICI). The review focus on the recent immunooncology developments and available trial results within the last 12 months.

Recent findings ICI as monotherapy (nivolumab) or immunooncology and immunooncology combinations (nivolumab and ipilimumab) demonstrated positive results on prolonged overall survival in phase III trials. The combination of ICI (atezolizumab) and bevacizumab provided positive signals in prolonged PFS in the PD-L1 positive subgroup. Combinations of ICI and TKI are promising in early phase I and phase II trials. Results are currently expanded in larger phase III studies. The combination of vaccine and TKI in mRCC has not provided beneficial results so far.

Summary The current treatment landscape in mRCC is shifting towards immunooncology agents, which already gained ground in the clinic as ICI monotherapy (nivolumab) or is likely to do in the near future as ICI combination (nivolumab and ipilimumab). The future will hold promise of new combinations with TKIs and ICI or other immunooncology agents like vaccines and metabolic immune checkpoint inhibitors.

aDepartment of Urology, Eberhard Karls University, Tübingen, Germany

bDepartment of Urology, Diakonie Hospital, Schwäbisch Hall, Germany

Correspondence to Jens Bedke, Department of Urology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72070 Tuebingen, Germany. Tel: +49 7071 2980349; fax: +49 7071 295092; e-mail: bedke@live.com

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