Immunotherapy in renal cell carcinoma

The incorporation of nivolumab, an immune checkpoint inhibitor, into the treatment framework for treatment-refractory metastatic clear cell renal cell carcinoma has been crucial in improving outcomes for patients. 1 Motzer RJ Escudier B McDermott DF et al. Nivolumab versus everolimus in advanced renal-cell carcinoma. N Engl J Med. 2015; 373: 1803-1813 Crossref PubMed Scopus (4391) Google Scholar In the CheckMate-214 study, 2 Motzer RJ Tannir NM McDermott DF et al. Nivolumab plus ipilimumab versus sunitinib in advanced renal-cell carcinoma. N Engl J Med. 2018; 378: 1277-1290 Crossref PubMed Scopus (2858) Google Scholar ipilimumab, the first approved immune checkpoint inhibitor, was combined with nivolumab, which prolonged overall survival in treatment-naive patients. Disruption of cancer-induced immune tolerance with these drugs substantially improved all meaningful endpoints when compared with previous standards of care. 3 Navani V Heng DYC Treatment selection in first-line metastatic renal cell carcinoma-the contemporary treatment paradigm in the age of combination therapy: a review. JAMA Oncol. 2021; 8: 292-299 Crossref Scopus (25) Google Scholar Tailored immunotherapy approach with nivolumab with or without nivolumab plus ipilimumab as immunotherapeutic boost in patients with metastatic renal cell carcinoma (TITAN-RCC): a multicentre, single-arm, phase 2 trialIn treatment-naive patients, nivolumab induction with or without nivolumab plus ipilimumab boosts significantly improved the objective response rate compared with that reported for nivolumab monotherapy in the CheckMate-025 trial. However, overall efficacy seemed inferior when compared with approved upfront nivolumab plus ipilimumab. For second-line treatment, nivolumab plus ipilimumab could be a rescue strategy on progression with approved nivolumab monotherapy. Full-Text PDF