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Checkpoint Inhibitors for the Treatment of Renal Cell Carcinoma

  • Genitourinary Cancers (W Oh and M Galsky, Section Editors)
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

The advent of checkpoint inhibitors has revolutionized systemic therapy for many malignancies, including renal cell carcinoma (RCC) where multiple PD-1, PD-L1, and CTLA-4 inhibitors have demonstrated responses and improved survival for patients in clinical trials. Durable benefit with manageable toxicity can be achieved with these agents—but unfortunately for only a minority of individuals. Efforts are ongoing to understand mechanisms driving the response and resistance to checkpoint inhibitors in order to personalize therapy and extend benefit to more patients. In particular, combination immunotherapy is an area of active study with multiple ongoing trials in RCC. Novel immunotherapeutic agents are being explored as well. Clinically, there are nuances related to the use of immunotherapy that are important to understand in order to provide optimal care to patients. Potential autoimmune toxicities are important to identify early so they can be best mitigated with immunosuppression, and careful review of imaging with clinical correlation is important to ensure responding patients are not taken off treatment prematurely due to “pseudo-progression.” Lastly, although immunotherapy is an important new tool, it exists among other active agents in the treatment of RCC, and further study is needed to understand where it best fits in the treatment paradigm. In this article, we review the most recent data for immune checkpoint inhibitors in metastatic renal cell carcinoma and more broadly discuss the rapidly evolving landscape of immunotherapy in RCC, including combination immunotherapies.

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Authors and Affiliations

  1. Department of Hematology/Oncology, Fox Chase Cancer Center, Temple Health, 333 Cottman Avenue, Philadelphia, PA, 19111-2497, USA

    Pooja Ghatalia MD, Matthew Zibelman MD, Daniel M. Geynisman MD & Elizabeth R. Plimack MD, MS

Authors
  1. Pooja Ghatalia MD
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  2. Matthew Zibelman MD
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  3. Daniel M. Geynisman MD
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  4. Elizabeth R. Plimack MD, MS
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Corresponding author

Correspondence to Elizabeth R. Plimack MD, MS.

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Conflict of Interest

Pooja Ghatalia declares that she has no conflict of interest.

Matthew Zibelman has received institution-directed funds for clinical research from Horizon Pharma and served on an advisory board for EMD Serono and has a patent pending on interferon-gamma and nivolumab in multiple cancers (including RCC).

Daniel M. Geynisman has received financial support through grants from Millennium, Merck, Genentech, and Pfizer and has received compensation from Exelixis and Pfizer for service as a consultant.

Elizabeth R. Plimack has received support through grants to her institution for clinical trial costs from Acceleron, AstraZeneca, Aveo, Bristol-Myers Squibb, Dendreon, Eli Lilly, Inc., Merck, Novartis, Peloton, and Pfizer; has received compensation from Acceleron, AstraZeneca, Bristol-Myers Squibb, Dendreon, Exelixis, Genentech/Roche, Merck, Novartis, and Pfizer for scientific advisory and/or training; has received compensation from Eli Lilly, Inc., Pfizer, and Synergene for data safety monitoring; and has a patent (US Patent Application no. 14/588,503, filed January 2, 2015) pending.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Genitourinary Cancers

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Ghatalia, P., Zibelman, M., Geynisman, D.M. et al. Checkpoint Inhibitors for the Treatment of Renal Cell Carcinoma. Curr. Treat. Options in Oncol. 18, 7 (2017). https://doi.org/10.1007/s11864-017-0458-0

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  • DOI: https://doi.org/10.1007/s11864-017-0458-0

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