Department of Urology, Medical University of Vienna.
Department of Internal Medicine 1, Division of Oncology, Medical University of Vienna, Vienna, Austria.
Curr Opin Urol. 2020 Jul;30(4):534-541. doi: 10.1097/MOU.0000000000000788.
The aim of the article to summarize recent changes of treatment options in metastatic renal cell carcinoma (mRCC) with a special emphasis on immune checkpoint inhibition.
The introduction of checkpoint inhibitor (CPI) therapy has led to a paradigm change in advanced renal cell carcinoma (RCC). Dual immune checkpoint inhibition or the combination of CPI and tyrosine kinase inhibitors (TKIs) was shown to improve survival when compared with the former standard of care sunitinib. Moreover, these novel strategies were shown to enable unprecedented rates of complete and durable responses, particularly with dual checkpoint inhibition. Although the treatment landscape has rapidly evolved, it remains unknown which combination is the best for the individual patient. Pivotal trials have used sunitinib as a comparator but no head to head comparisons have been conducted between novel agents so far. Moreover, no predictive biomarker has been identified yet to bring the best treatment to the individual patient.
The aim of this review is to summarize the findings of CPI-based trials conducted in RCC and to discuss the future of mRCC treatment.
本文旨在总结转移性肾细胞癌（mRCC）治疗选择的最新变化，特别强调免疫检查点抑制。
检查点抑制剂（CPI）治疗的引入使晚期肾细胞癌（RCC）的治疗模式发生了改变。与以前的标准治疗药物舒尼替尼相比，双重免疫检查点抑制或 CPI 与酪氨酸激酶抑制剂（TKI）联合应用可提高生存率。此外，这些新策略显示出前所未有的完全和持久反应率，尤其是双重检查点抑制。尽管治疗领域发展迅速，但仍不清楚哪种组合对个体患者最好。关键性试验使用舒尼替尼作为对照，但迄今为止，尚未对新型药物进行头对头比较。此外，目前还没有确定预测生物标志物来为个体患者提供最佳治疗。
本综述的目的是总结 RCC 中基于 CPI 的试验结果，并讨论 mRCC 治疗的未来。
