Nivolumab as the new standard of metastatic kidney cancer treatment

V B Matveev

doi:10.17650/1726-9776-2017-13-3-18-26

Abstract

The last decade was marked by the rapid development of kidney cancer drug treatment and advent of targeted drugs aimed at inhibition of angiogenesis which plays a crucial role in tumor growth. Despite certain success, targeted antiangiogenetic therapy with tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors (mTOR), and monoclonal antibodies against vascular endothelial growth factor (VEGF) in most cases do not achieve long-term remission, are highly toxic, and never lead to full cure for the patients. Development of modern immunological approaches to application of inhibitors of the crucial immune response regulators opens up new possibilities in treatment of disseminated kidney cancer. In this review, results of the studies of nivolumab (PD-1 inhibitor), first checkpoint inhibitor registered for treatment of metastatic kidney cancer are presented.

Highlights

The last decade was marked by the rapid development of kidney cancer drug treatment and advent of targeted drugs aimed at inhibition of angiogenesis which plays a crucial role in tumor growth
Despite certain success, targeted antiangiogenetic therapy with tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors, and monoclonal antibodies against vascular endothelial growth factor (VEGF) in most cases do not achieve long-term remission, are highly toxic, and never lead to full cure for the patients
Development of modern immunological approaches to application of inhibitors of the crucial immune response regulators opens up new possibilities in treatment of disseminated kidney cancer

Summary

Introduction

CheckMate 025 – рандомизированное исследование III фазы, сравнивающее препараты ниволумаб в дозе 3 мг/кг каждые 2 нед и эверолимус в дозе 10 мг/сут у пациентов со светлоклеточным вариантом метастатического рака почки, ранее получавших 1 или более линий антиангиогенной терапии. Общая частота ответов составила 26 % у больных, получавших ниволумаб (по сравнению с 5 % у пациентов, принимавших эверолимус), при медиане длительности ответа 12,0 мес и медиане до наступления Экспрессия PD–L1 не может считаться надежным предиктивным биомаркером для терапии ниволумабом у больных раком почки.

Results

Conclusion