Nivolumab in the treatment of advanced renal cell carcinoma: clinical trial evidence and experience
Renal cell carcinoma (RCC) is considered an immunogenic tumor with a prominent dysfunctional immune cell infiltrate, unable to control tumor growth. Cytokine-based immunotherapies, including interferon-α and interleukin-2, have been used for the treatment of metastatic RCC (mRCC). Long-term response...
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doaj-1dfe893e8bd24c959752a84da62ac6d02020-11-25T03:16:17ZengSAGE PublishingTherapeutic Advances in Urology1756-28721756-28802016-10-01810.1177/1756287216656811Nivolumab in the treatment of advanced renal cell carcinoma: clinical trial evidence and experienceAlessia MennittoPaolo GrassiRaffaele RattaElena VerzoniMichele PrisciandaroGiuseppe ProcopioRenal cell carcinoma (RCC) is considered an immunogenic tumor with a prominent dysfunctional immune cell infiltrate, unable to control tumor growth. Cytokine-based immunotherapies, including interferon-α and interleukin-2, have been used for the treatment of metastatic RCC (mRCC). Long-term responses and complete remissions were observed, but durable clinical benefit efficacy in the overall population was limited and associated with significant toxicity. As a consequence, new generation agents targeting the vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) pathways replaced interferon alpha (IFN-α). Strategies of tumor immune evasion include T-cell suppression by negative signals deriving from the interaction between programmed death-1 (PD-1) on the T cell and its ligand (PDL-1) on the tumor cells. Nivolumab, a programmed death 1 checkpoint inhibitor, blocks this pathway, thus reversing T-cell suppression and activating antitumor responses. The aim of this review is to summarize the safety and efficacy data of nivolumab in mRCC. Objective responses and safety profile of single-agent nivolumab are favorable in both previously treated and treatment-naïve mRCC patients. Despite toxic effects, combination therapies with nivolumab have shown promising results, indicating a potential role in the treatment of mRCC. Tailoring immunotherapy on a patient-to-patient basis represents a major challenge for the future.https://doi.org/10.1177/1756287216656811 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Alessia Mennitto Paolo Grassi Raffaele Ratta Elena Verzoni Michele Prisciandaro Giuseppe Procopio |
spellingShingle |
Alessia Mennitto Paolo Grassi Raffaele Ratta Elena Verzoni Michele Prisciandaro Giuseppe Procopio Nivolumab in the treatment of advanced renal cell carcinoma: clinical trial evidence and experience Therapeutic Advances in Urology |
author_facet |
Alessia Mennitto Paolo Grassi Raffaele Ratta Elena Verzoni Michele Prisciandaro Giuseppe Procopio |
author_sort |
Alessia Mennitto |
title |
Nivolumab in the treatment of advanced renal cell carcinoma: clinical trial evidence and experience |
title_short |
Nivolumab in the treatment of advanced renal cell carcinoma: clinical trial evidence and experience |
title_full |
Nivolumab in the treatment of advanced renal cell carcinoma: clinical trial evidence and experience |
title_fullStr |
Nivolumab in the treatment of advanced renal cell carcinoma: clinical trial evidence and experience |
title_full_unstemmed |
Nivolumab in the treatment of advanced renal cell carcinoma: clinical trial evidence and experience |
title_sort |
nivolumab in the treatment of advanced renal cell carcinoma: clinical trial evidence and experience |
publisher |
SAGE Publishing |
series |
Therapeutic Advances in Urology |
issn |
1756-2872 1756-2880 |
publishDate |
2016-10-01 |
description |
Renal cell carcinoma (RCC) is considered an immunogenic tumor with a prominent dysfunctional immune cell infiltrate, unable to control tumor growth. Cytokine-based immunotherapies, including interferon-α and interleukin-2, have been used for the treatment of metastatic RCC (mRCC). Long-term responses and complete remissions were observed, but durable clinical benefit efficacy in the overall population was limited and associated with significant toxicity. As a consequence, new generation agents targeting the vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) pathways replaced interferon alpha (IFN-α). Strategies of tumor immune evasion include T-cell suppression by negative signals deriving from the interaction between programmed death-1 (PD-1) on the T cell and its ligand (PDL-1) on the tumor cells. Nivolumab, a programmed death 1 checkpoint inhibitor, blocks this pathway, thus reversing T-cell suppression and activating antitumor responses. The aim of this review is to summarize the safety and efficacy data of nivolumab in mRCC. Objective responses and safety profile of single-agent nivolumab are favorable in both previously treated and treatment-naïve mRCC patients. Despite toxic effects, combination therapies with nivolumab have shown promising results, indicating a potential role in the treatment of mRCC. Tailoring immunotherapy on a patient-to-patient basis represents a major challenge for the future. |
url |
https://doi.org/10.1177/1756287216656811 |
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