Atezolizumab for the treatment of renal cell carcinoma

ABSTRACT

Introduction

The therapeutic landscape of renal cell cancer has evolved rapidly over the past 2 years with nivolumab and ipilimumab for patients with metastatic disease and an intermediate or poor prognosis, in the first line setting. More recently, data from trials combining antiangiogenic agents and immune checkpoint inhibitors demonstrated a major benefit of this treatment approach for all patients.

Areas covered

One of three recent trials evaluated the combination of atezolizumab, an anti-programmed death ligand 1 antibody, with bevacizumab, an anti-vascular endothelial growth factor monoclonal antibody. In this manuscript, we summarize the preclinical, clinical, and safety data on atezolizumab for treatment of renal cell carcinoma and describe ongoing trials.

Expert opinion

Atezolizumab was evaluated in combination with an antiangiogenic agent. These trials were designed based on the hypothesis that selecting patients according to the expression of programmed death ligand 1 would increase the benefit of the treatment combination. Despite positive effects on the primary endpoints progression-free survival and response rate in this selected population, overall survival in the global population did not meet the criteria for significance at the time of the intermediate analysis. The major information was a proposed tumor gene expression signature. The signature was predictive of the sensitivity to anti-angiogenic and/or immune checkpoint inhibitor therapy.

KEYWORDS:

• Atezolizumab
• renal cell cancer
• bevacizumab
• immune checkpoint inhibitor
• antiangiogenic

Article highlights

• Atezolizumab is an anti-PD-L1 antibody efficacy in several tumors

• Preclinical and clinical data have shown encouraging results for its use on the treatment of metastatic renal cell carcinoma alone or with anti angiogenic

• Combination of atezolizuma and bevacizumab profile is acceptable

• A signature with tumor gene expression was developed to predictive of the sensitivity to anti-angiogenic and/or immune checkpoint inhibitor therapy.

This box summarizes key points contained in the article.

Declaration of interest

A Ravaud has received honoraria for consultancy from Pfizer, Astra Zeneca, MSD, BMS, Roche, and Ipsen; is a member of the GU for Pfizer, Astra Zeneca, MSD, BMS, Roche and Ipsen; and has received transportation and housing for meetings from Pfizer, Astra Zeneca, BMS and Ipsen. M Gross-Goupil is a member of GU board for Pfizer, Astra Zeneca, MSD, BMS, Roche and Ipsen; has received transportation and housing for meetings from Pfizer, BMS, Janssen, Ipsen, Roche, MSD, Amgen, Astellas; and has received honoraria for symposiums from MSD, BMS, Pfizer. A Daste has received honoraria for consultancy for Astra-Zeneca, BMS, MSD, Roche, Merck. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Box 1. Drug summary

Table

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper is not funded.