Novel immunotherapy approaches for metastatic urothelial and renal cell carcinoma

Asian Journal of Urology, 2016, 3 (4): 268-277 doi:

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Novel immunotherapy approaches for metastatic urothelial and renal cell carcinoma

Zhiying Shao^a, Andrew Z. Wang^b, Daniel J. George^c, Tian Zhang^d

a Department of Medical Oncology, The Affiliated Hospital of Xuzhou Medical University, Jiangsu Center for the Collaboration and Innovation of Cancer Biotherapy, Cancer Institute, Xuzhou Medical University, Xuzhou, Jiangsu, China;
b Department of Radiation Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
c Division of Medical Oncology, Department of Medicine, Division of Urology, Department of Surgery, Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA;
d Division of Medical Oncology, Department of Medicine, Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA

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Abstract The treatment of metastatic renal cell carcinoma (RCC) and urothelial carcinoma (UC) remains a major challenge. Past research has implicated the immune system in tumor surveillance of both malignancies, leading to the application of immunotherapy agents for both cancers. Among them, the most promising agents are the checkpoint blockade drugs, such as antibodies targeting the cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), programmed death receptor 1 (PD-1), and PD-1 ligand (PD-L1). In normal physiology, these immune checkpoints act as inhibitory signals to fine-tune the duration and strength of immune reactions, which is pivotal for maintaining self-tolerance. However, tumor cells also utilize immune checkpoint pathways to evade anti-tumor immune response, leading to disease progression and metastasis. Thus, there has been intense preclinical and clinical effort focused on the application of checkpoint inhibitors in metastatic RCC and UC. To date, nivolumab (anti-PD-1) and atezolizumab (anti-PD-L1) have been approved for the treatment of metastatic RCC and UC, respectively. Despite these successes, challenges remain in how to further improve response rates to immunotherapy and how to select patients that will benefit from this approach. In this report, we review existing data and research on immunotherapy in metastatic RCC and UC.

Key words： Immune checkpoint inhibitors Nivolumab Atezolizumab Pembrolizumab Renal cell carcinoma Urothelial carcinoma

Received: 18 June 2016 Published: 02 November 2016

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Zhiying Shao,Andrew Z. Wang,Daniel J. George, et al. Novel immunotherapy approaches for metastatic urothelial and renal cell carcinoma[J]. Asian Journal of Urology, 2016, 3(4): 268-277.

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http://www.ajurology.com/EN/ OR http://www.ajurology.com/EN/Y2016/V3/I4/268

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