Role of immunotherapy for renal cell cancer in 2011

Abstract

High-dose interleukin-2 (IL-2) and interferon were the most commonly administered therapies before the recent introduction of targeted agents, including vascular endothelial growth factor and mammalian target of rapamycin pathway inhibitors. Although the new agents result in a progression-free survival benefit, high-dose IL-2 remains the only agent with proven efficacy in producing durable complete and partial responses in patients with metastatic renal cell carcinoma (RCC). Furthermore, although the use of single-agent interferon has decreased significantly since the introduction of targeted therapy, it remains in the frontline setting in combination with bevacizumab as a result of 2 large phase III trials. Lastly, improved understanding of immune regulation has led to the advancement of targeted immunotherapy using immune checkpoint inhibitors that have shown promising activity and are moving forward in clinical development. This article focuses on the current status of immunotherapy in the management of metastatic RCC.

Trial registration: ClinicalTrials.gov NCT00441337 NCT01354431.

Figures

Figure 1

Progression-free survival according to University of California, Los Angeles Survival After Nephrectomy and Immunotherapy risk group. Abbreviation: Int, intermediate. Courtesy of David McDermott, MD, Boston, MA. Presented at the 2010 ASCO Annual Meeting; June 4–8, 2010; Chicago, Illinois.

Figure 2

Schematic illustration of antigen-presenting cell/tumor cell and T-cell receptor interaction in T cell activation. Abbreviation: APC, antigen-presenting cell. From Nature Reviews: Immunology; with permission.