Targeted therapy in renal cell carcinoma: moving from molecular agents to specific immunotherapy

World J Urol. 2014 Feb;32(1):31-8. doi: 10.1007/s00345-013-1033-3. Epub 2013 Feb 12.

Abstract

Non-specific immunotherapy has been for a long time a standard treatment option for patients with metastatic renal cell carcinoma but was redeemed by specific targeted molecular therapies, namely the VEGF and mTOR inhibitors. After moving treatment for mRCC to specific molecular agents with a well-defined mode of action, immunotherapy still needs this further development to increase its accuracy. Nowadays, an evolution from a rather non-specific cytokine treatment to sophisticated targeted approaches in specific immunotherapy led to a re-launch of immunotherapy in clinical studies. Recent steps in the development of immunotherapy strategies are discussed in this review with a special focus on peptide vaccination which aims at a tumor targeting by specific T lymphocytes. In addition, different combinatory strategies with immunomodulating agents like cyclophosphamide or sunitinib are outlined, and the effects of immune checkpoint modulators as anti-CTLA-4 or PD-1 antibodies are discussed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols
  • Cancer Vaccines / therapeutic use
  • Carcinoma, Renal Cell / drug therapy*
  • Humans
  • Immunotherapy / methods
  • Immunotherapy / trends*
  • Kidney Neoplasms / drug therapy*
  • Molecular Targeted Therapy / methods
  • Molecular Targeted Therapy / trends*
  • TOR Serine-Threonine Kinases / antagonists & inhibitors
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors

Substances

  • Antineoplastic Agents
  • Cancer Vaccines
  • Vascular Endothelial Growth Factor A
  • TOR Serine-Threonine Kinases