Cargando…

New First Line Treatment Options of Clear Cell Renal Cell Cancer Patients with PD-1 or PD-L1 Immune-Checkpoint Inhibitor-Based Combination Therapies

In metastatic renal cell carcinoma (mRCC) the PD-1 immune-checkpoint inhibitor (ICI) Nivolumab became a standard second line treatment option in 2015 based on a significant improvement of overall survival compared to Everolimus. Current pivotal phase 3 studies showed that PD-1 ICI-based combinations...

Descripción completa

Detalles Bibliográficos
Autores principales: Grimm, Marc-Oliver, Leucht, Katharina, Grünwald, Viktor, Foller, Susan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7074019/
https://www.ncbi.nlm.nih.gov/pubmed/32092974
http://dx.doi.org/10.3390/jcm9020565
_version_ 1783506743249076224
author Grimm, Marc-Oliver
Leucht, Katharina
Grünwald, Viktor
Foller, Susan
author_facet Grimm, Marc-Oliver
Leucht, Katharina
Grünwald, Viktor
Foller, Susan
author_sort Grimm, Marc-Oliver
collection PubMed
description In metastatic renal cell carcinoma (mRCC) the PD-1 immune-checkpoint inhibitor (ICI) Nivolumab became a standard second line treatment option in 2015 based on a significant improvement of overall survival compared to Everolimus. Current pivotal phase 3 studies showed that PD-1 ICI-based combinations were more efficacious than the VEGFR-TKI Sunitinib, a previous standard of care, leading to approval of three new regimens as guideline-recommended first-line treatment. Nivolumab plus Ipilimumab is characterized by a survival advantage, a high rate of complete response and durable remissions in intermediate and poor prognosis patients. Despite frequent immune-mediated side effects, fewer symptoms and a better quality of life were observed compared to Sunitinib. Pembrolizumab or Avelumab plus Axitinib were characterized by an improved progression-free-survival and a high response rate with a low rate of intrinsic resistance. In addition, Pembrolizumab plus Axitinib reached a significant survival benefit. The side effect profile is driven by the chronic toxicity of Axitinib, but there is additional risk of immune-mediated side effects of the PD-1/PD-L1 ICIs. The quality of life data published so far do not suggest any improvement regarding patient-reported outcomes compared to the previous standard Sunitinib. The PD-1/PD-L1 ICIs thus form the backbone of the first-line therapy of mRCC.
format Online
Article
Text
id pubmed-7074019
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-70740192020-03-19 New First Line Treatment Options of Clear Cell Renal Cell Cancer Patients with PD-1 or PD-L1 Immune-Checkpoint Inhibitor-Based Combination Therapies Grimm, Marc-Oliver Leucht, Katharina Grünwald, Viktor Foller, Susan J Clin Med Review In metastatic renal cell carcinoma (mRCC) the PD-1 immune-checkpoint inhibitor (ICI) Nivolumab became a standard second line treatment option in 2015 based on a significant improvement of overall survival compared to Everolimus. Current pivotal phase 3 studies showed that PD-1 ICI-based combinations were more efficacious than the VEGFR-TKI Sunitinib, a previous standard of care, leading to approval of three new regimens as guideline-recommended first-line treatment. Nivolumab plus Ipilimumab is characterized by a survival advantage, a high rate of complete response and durable remissions in intermediate and poor prognosis patients. Despite frequent immune-mediated side effects, fewer symptoms and a better quality of life were observed compared to Sunitinib. Pembrolizumab or Avelumab plus Axitinib were characterized by an improved progression-free-survival and a high response rate with a low rate of intrinsic resistance. In addition, Pembrolizumab plus Axitinib reached a significant survival benefit. The side effect profile is driven by the chronic toxicity of Axitinib, but there is additional risk of immune-mediated side effects of the PD-1/PD-L1 ICIs. The quality of life data published so far do not suggest any improvement regarding patient-reported outcomes compared to the previous standard Sunitinib. The PD-1/PD-L1 ICIs thus form the backbone of the first-line therapy of mRCC. MDPI 2020-02-19 /pmc/articles/PMC7074019/ /pubmed/32092974 http://dx.doi.org/10.3390/jcm9020565 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Grimm, Marc-Oliver
Leucht, Katharina
Grünwald, Viktor
Foller, Susan
New First Line Treatment Options of Clear Cell Renal Cell Cancer Patients with PD-1 or PD-L1 Immune-Checkpoint Inhibitor-Based Combination Therapies
title New First Line Treatment Options of Clear Cell Renal Cell Cancer Patients with PD-1 or PD-L1 Immune-Checkpoint Inhibitor-Based Combination Therapies
title_full New First Line Treatment Options of Clear Cell Renal Cell Cancer Patients with PD-1 or PD-L1 Immune-Checkpoint Inhibitor-Based Combination Therapies
title_fullStr New First Line Treatment Options of Clear Cell Renal Cell Cancer Patients with PD-1 or PD-L1 Immune-Checkpoint Inhibitor-Based Combination Therapies
title_full_unstemmed New First Line Treatment Options of Clear Cell Renal Cell Cancer Patients with PD-1 or PD-L1 Immune-Checkpoint Inhibitor-Based Combination Therapies
title_short New First Line Treatment Options of Clear Cell Renal Cell Cancer Patients with PD-1 or PD-L1 Immune-Checkpoint Inhibitor-Based Combination Therapies
title_sort new first line treatment options of clear cell renal cell cancer patients with pd-1 or pd-l1 immune-checkpoint inhibitor-based combination therapies
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7074019/
https://www.ncbi.nlm.nih.gov/pubmed/32092974
http://dx.doi.org/10.3390/jcm9020565
work_keys_str_mv AT grimmmarcoliver newfirstlinetreatmentoptionsofclearcellrenalcellcancerpatientswithpd1orpdl1immunecheckpointinhibitorbasedcombinationtherapies
AT leuchtkatharina newfirstlinetreatmentoptionsofclearcellrenalcellcancerpatientswithpd1orpdl1immunecheckpointinhibitorbasedcombinationtherapies
AT grunwaldviktor newfirstlinetreatmentoptionsofclearcellrenalcellcancerpatientswithpd1orpdl1immunecheckpointinhibitorbasedcombinationtherapies
AT follersusan newfirstlinetreatmentoptionsofclearcellrenalcellcancerpatientswithpd1orpdl1immunecheckpointinhibitorbasedcombinationtherapies