The interplay between inflammation, anti-angiogenic agents, and immune checkpoint inhibitors: Perspectives for renal cell cancer treatment

Nicole Brighi, Alberto Farolfi, Vincenza Conteduca, Giorgia Gurioli, Stefania Gargiulo, Valentina Gallà, Giuseppe Schepisi, Cristian Lolli, Chiara Casadei, Ugo De Giorgi

Research output: Contribution to journalReview article

Abstract

Treatment options for metastatic renal cell carcinoma (RCC) have been expanding in the last years, from the consolidation of several anti-angiogenic agents to the approval of immune checkpoint inhibitors (ICIs). The rationale for the use of immunomodulating agents derived from the observation that RCC usually shows a diffuse immune-cell infiltrate. ICIs target Cytotoxic T Lymphocytes Antigen 4 (CTLA-4), programmed death 1 (PD-1), or its ligand (PD-L1), showing promising therapeutic efficacy in RCC. PD-L1 expression is associated with poor prognosis; however, its predictive role remains debated. In fact, ICIs may be a valid option even for PD-L1 negative patients. The establishment of valid predictors of treatment response to available therapeutic options is advocated to identify those patients who could benefit from these agents. Both local and systemic inflammation contribute to tumorigenesis and development of cancer. The interplay of tumor-immune status and of cancer-related systemic inflammation is pivotal for ICI treatment outcome, but there is an unmet need for a more precise characterization. To date, little is known on the role of inflammation markers on PD-1 blockade in RCC. In this paper, we review the current knowledge on the interplay between inflammation markers, PD-1 axis, and anti-angiogenic agents in RCC, focusing on biological rationale, implications for treatment, and possible future perspectives.

Original languageEnglish
Article number1935
JournalCancers
Volume11
Issue number12
DOIs
Publication statusPublished - Dec 2019

Keywords

  • Immune checkpoint inhibitors
  • Immunotherapy
  • Inflammation markers
  • Kidney cancer
  • Predictive factors
  • Prognostic factors
  • Programmed deathligand1
  • Renal cell

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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