Abstract
Introduction: Immune-based therapies (e.g., IL-2, IFN) have been used for some time in advanced clear cell renal cell carcinoma (RCC) with overall modest success. Recent advances have demonstrated that tumor cells evade immune-mediated destruction by inducing inhibitory signals that result in effector T-cell exhaustion. One mechanism involves interaction between the T-cell programmed death-1 (PD-1) receptor and its ligand, PD ligand-1, expressed on tumor and inflammatory cells. Nivolumab, an anti-PD-1 antibody, blocks this pathway, thereby reversing T-cell suppression and activating antitumor responses.
Areas covered: In this review, the authors summarize selected aspects of PD-1 signaling, the development of immune checkpoint therapeutic agents, and clinical data regarding the safety and efficacy of nivolumab in RCC from Phase I and II clinical trials.
Expert opinion: Objective responses and safety profiles of single-agent nivolumab are favorable in patients with previously treated and treatment-naive metastatic RCC. Combination therapies involving nivolumab are ongoing and have generated encouraging results. The use of nivolumab will have substantial impact on the management of patients with RCC.
Declaration of interets
The authors have no 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. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.