Immune checkpoint modulation in renal cell carcinoma
In this paper, Bedke and colleague highlight the way that patients treated for the metastatic disease in renal cell carcinoma (mRCC) by a cytokine treatment (cytokine Il-2 and IFN-α alone or combine with 5-Fluoracil) have experienced a disease stabilization or remission in up of 30% of the patients. But only for some months. It is a limited therapy due to the increase of regulatory T cells (Tregs and decreasing of circulating myeloid and plasmacytoid dendritic cells. In this paper, the authors highlight a new way to address renal cell carcinoma treatment targetting immune checkpoint modulation (PD-1, CTLA-4,…). They review the ongoing clinical data linked to the use of such immune checkpoint modulation pathway in the renal carcinoma.
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Summary | The introduction of targeted therapies like the tyrosine kinase (TKI) and mammalian target of rapamycin (mTOR) inhibitors has improved patients survival in general. Nevertheless, the prognosis remains limited. Therapies with a new mode of action are urgently warranted, especially those who would provoke long-term responders or long-lasting complete remissions as observed with unspecific immunotherapy with the cytokines interleukin-2 and interferon-a. In the recent years, a deeper understanding of the underlying immunology of T cell activation led to the development of checkpoint inhibitors, which are mainly monoclonal antibodies and which enhances the presence of the co-stimulatory signals needed for T cell activation or priming. This review discusses the clinical data and ongoing studies available for the inhibition of the PD-1 (CD279) and CTLA-4 (CD152) axis in mRCC. In addition, potential future immunological targets are discussed. This approach of T-cell activation or re-activation by immunological checkpoint inhibition holds the inherent promise to directly affect the tumor cell and thereby to potentially cure a subset of patients with mRCC.
LEARN MORE | Bedke et al. Hum. Vaccines Immunother, 2015
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