Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Department of Urology, Shiga University of Medical Science, Otsu, Japan.
Expert Rev Anticancer Ther. 2022 Jun;22(6):647-655. doi: 10.1080/14737140.2022.2075347. Epub 2022 May 11.
Immune checkpoint inhibitors (ICIs) have made an appearance in clinical practice, and the treatment outcome of metastatic renal cell cancer (mRCC) has dramatically improved as a result. Currently, most patients are treated with a combination of ICIs or a combination of ICI and tyrosine kinase inhibitors (TKIs). These new therapeutic tools need to be organized and summarized in order to realize and advance personalized therapy for mRCC.
In this review, the characteristics of five regimens (nivolumab plus ipilimumab, pembrolizumab plus axitinib, avelumab plus axitinib, and nivolumab plus cabozantinib and pembrolizumab plus lenvatinib) are briefly elucidated and their efficacies and safety profiles are compared. For ICI-unfit patients, the current choices are examined. In addition, the potential second-line regimens after these combination therapies are introduced as sequential treatment. Finally, in the future direction section, ongoing clinical trials are also introduced.
ICIs are rapidly being introduced for the treatment of mRCC. Currently, most patients are treated with a combination of ICIs or a combination of ICI and TKIs. In order to develop optimal personalized treatment for our patients, it is necessary for the physicians who treat mRCC patients to possess in-depth knowledge of these new therapeutic tools.
免疫检查点抑制剂(ICIs)已在临床实践中出现,转移性肾细胞癌(mRCC)的治疗效果因此得到显著改善。目前,大多数患者接受 ICI 联合治疗或 ICI 联合酪氨酸激酶抑制剂(TKI)治疗。为了实现和推进 mRCC 的个体化治疗,这些新的治疗手段需要进行组织和总结。
在这篇综述中,简要阐述了五种方案(nivolumab 联合 ipilimumab、pembrolizumab 联合 axitinib、avelumab 联合 axitinib、nivolumab 联合 cabozantinib 和 pembrolizumab 联合 lenvatinib)的特点,并比较了它们的疗效和安全性。对于不适合使用 ICI 的患者,目前的选择也进行了检查。此外,还介绍了这些联合治疗后的潜在二线治疗方案作为序贯治疗。最后,在未来方向部分,还介绍了正在进行的临床试验。
ICI 正在迅速被引入 mRCC 的治疗中。目前,大多数患者接受 ICI 联合治疗或 ICI 联合 TKI 治疗。为了为我们的患者制定最佳的个体化治疗方案,治疗 mRCC 的医生需要深入了解这些新的治疗手段。