PD-1 as an emerging therapeutic target in renal cell carcinoma: current evidence

SS Tykodi - OncoTargets and therapy, 2014 - Taylor & Francis
OncoTargets and therapy, 2014Taylor & Francis
Renal cell carcinoma (RCC) is the most common primary malignant tumor of the kidney in
adults, representing approximately 4% of all adult cancers in the United States. Metastatic
RCC is poorly responsive to conventional cytotoxic chemotherapies but can be sensitive to T-
cell-directed immunotherapies such as interferon-α or interleukin-2. Despite recent progress
in the application of antiangiogenic “targeted therapies” for metastatic RCC, high-dose
interleukin-2 remains an appropriate first-line therapy for select patients and is associated …
Renal cell carcinoma (RCC) is the most common primary malignant tumor of the kidney in adults, representing approximately 4% of all adult cancers in the United States. Metastatic RCC is poorly responsive to conventional cytotoxic chemotherapies but can be sensitive to T-cell-directed immunotherapies such as interferon-α or interleukin-2. Despite recent progress in the application of antiangiogenic “targeted therapies” for metastatic RCC, high-dose interleukin-2 remains an appropriate first-line therapy for select patients and is associated with durable complete remissions in a small fraction of treated patients. Thus, advanced RCC provides a unique opportunity to investigate the requirements for effective antitumor immunotherapy. Accumulating evidence suggests that resistance mechanisms exploited by RCC and other tumor types may play a dominant role in limiting the effectiveness of tumor-reactive adaptive immune responses. Expression of the inhibitory coreceptor programmed cell death-1 (PD-1) on tumor-infiltrating lymphocytes within RCC tumors, as well as the expression of the PD-1 ligand (PD-L1) on RCC tumor cells, are strong negative prognostic markers for disease-specific death in RCC patients. Monoclonal antibodies targeting either PD-1 or PD-L1 have now entered clinic trials and have demonstrated promising antitumor effects for refractory metastatic RCC. This review summarizes the results of published and reported studies of PD-1- and PD-L1-targeted therapies enrolling patients with advanced RCC, focusing on key safety, toxicity, and efficacy end points. Prospects for advanced phase clinical testing and novel therapy combinations with PD-1- and PD-L1-targeted agents are discussed.
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