Immunotherapy in kidney cancer: the past, present, and future.

Abstract

Kidney cancer, in particular clear cell renal cell carcinoma (ccRCC) has long been considered to be sensitive to immunotherapies. With the recent breakthroughs in immunotherapy for solid tumors and the recent approval of the first immune checkpoint inhibitor for ccRCC, we are reviewing the history of immunotherapy in kidney cancer, describing its current state and look into the future of a rapidly evolving landscape in immunotherapy for kidney cancer. Systemic treatment options over the past decade have been dominated by targeted therapies inhibiting the vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) pathways. With the approval of the immune checkpoint inhibitor nivolumab, a new era of potential combination therapies is about to shape the treatment landscape for kidney cancer. These include other immune checkpoint inhibitors (e.g., anti-CTLA4), modifiers of the tumor microenvironment (VEGF pathway, T cell agonists (anti-41BB and Ox40 antibodies), and novel vaccination strategies). With the development of more effective combination immunotherapies, we will witness significant changes in the treatment landscape for kidney cancer over the next few years. Combination immunotherapies are expected to become the first line treatment option in kidney cancer.