Tyrosine kinase inhibitors and immunotherapy combinations in renal cell carcinoma

Author:

Rassy Elie12,Flippot Ronan1,Albiges Laurence3

Affiliation:

1. Department of Cancer Medicine, Gustave Roussy, Université Paris-Saclay, Villejuif, France

2. Department of Medical Oncology, Saint Joseph University, Beirut, Lebanon

3. Department of Cancer Medicine, Gustave Roussy Institute, Université Paris-Saclay, 114 rue Edouard Vaillant, Villejuif, 94805, France

Abstract

The treatment landscape of metastatic renal cell carcinoma (mRCC) has been transformed with the advent of antiangiogenics, notably tyrosine kinase inhibitors (TKIs) targeting vascular endothelial growth factor receptor (VEGFR), and immune checkpoint inhibitors (ICIs). Both treatment options have improved outcomes of patients and modified the natural history of mRCC. Clinical investigations have focused on evaluating combination regimens containing ICIs and VEGFR-directed TKIs. Namely, the combinations of axitinib plus pembrolizumab (KEYNOTE-426) and axitinib plus avelumab (JAVELIN RENAL 101) have shown improved outcomes compared with sunitinib in treatment-naïve patients with mRCC. In this review, we discuss the clinical data of single-agent TKIs and ICIs in mRCC and the rationale for the combination ICIs and TKIs based on preclinical and clinical evidence. We also explore the current challenges for regimen selection and development of predictive biomarkers.

Publisher

SAGE Publications

Subject

Oncology

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