Integrating Immune Checkpoint Blockade Into Management Decisions in Kidney Cancer
Properly integrating immune checkpoint blockade into the treatment paradigm for metastatic renal cell carcinoma has become challenging, given the availability of many newer agents and ongoing trials of combination strategies. Matthew Zibelman, MD, and Elizabeth R. Plimack, MD, MS, of Fox Chase Cancer Center and Temple Health, Philadelphia, offer some perspective on the current landscape of integrating immunotherapy into management decisions and predict how these new paradigms may evolve for patients with this type of cancer, in the June 2017 issue of the Journal of the National Comprehensive Cancer Network.
Currently, there is little guidance on how best to use the array of systemic agents now available for renal cell carcinoma, long considered a malignancy with immunogenic potential. The authors focus on various treatment options for metastatic renal cell carcinoma, starting with second-line options and beyond. They review clinical trial data on the monoclonal antibody targeted programmed cell death protein 1 nivolumab, followed by lenvatinib and cabozantinib.
Next up is the first-line metastatic setting, with the benefits of agents such as sunitinib and pazopainb, as well as combination approaches with immune checkpoint blockers, reviewed. The authors also provide a glimpse at neoadjuvant approaches and the search for predictive biomarkers.