Renewed interest in immunotherapy in treating kidney cancer

Thu, 13 Nov 2014

There is a renewed interest from medical researchers to further investigate the efficacy of immunotherapy for treating kidney cancer following the improved understanding of basic cancer immunology, according to cancer experts during the EAU-ICUD Medical Treatment of Urological Malignancies meeting which opened today in Lisbon, Portugal.

“In recent years we have seen a renewed interest from researchers. There is a doubling of abstracts at major conferences from 2009 and 2012. And approximately 800 clinical trials in various phases are ongoing in breast, colon, head and neck, kidney, etc.” said Allan Pantuck (USA).

The day-long EAU-ICUD meeting, which preceded the 6th European Multidisciplinary Meeting on Urological Cancers (EMUC), aims to gather experts in urological cancers and collate their consensus on various medical strategies for kidney, prostate, testis, bladder and penile cancers.

Christian Stief (DE), who co-chaired the meeting with Profs. Christopher Evans (USA) and Karim Fizazi (FR), said the online publication of the consensus document is expected to be released at the EAU Congress in Madrid.

“The committees and groups composed of experts from various countries were hard at work, and we are grateful for their contributions. We are excited with the final outcome of this consensus work which covers main urological malignancies,” said Stief.

The first session tackled renal cell carcinoma covering first-line targeted therapy, second and third-line therapeutic options and the prospects in immunotherapy and other alternative approaches.

Pantuck gave an overview on immunotherapy and said the discovery of a new class of drugs and checkpoint inhibitors have given rise to the renewed interest on immunotherapy. He also mentioned the benefits of immunotherapy such as its systemic and highly specific effect on tumour cells and ability to adapt to antigenic changes over time.

Cora Sternberg (IT) discussed the committee’s recommendations and consensus on topics such as interleukin-2, interferon, cytokines plus targeted therapies, immune checkpoint inhibitors and therapeutic cancer vaccines.

Among the highlights mentioned by Sternberg were:

On Interleukin-2: High dose intravenous IL-2 is currently the only approved treatment for mRCC that offers the possibility of long-term remission but should be used as first-line treatment only in carefully selected patients.

On Interferon: A meta-analysis of four randomized, prospective clinical trials by the Cochrane collaboration reported a higher remission rate of 12.5% for the IFNalpha group, compared to 1.5% for the control group. IFN was associated with a significant survival benefit with a median OS improvement of 3.8 months.

On Cytokines Plus Targeted Therapies: IFN with Bevacizumab has yielded encouraging results and remains a first line treatment option for patients with mRCC.

On Monoclonal Antibody Therapy (mAbs): mAbs targeting RCC cell surface molecules have been developed for imaging and therapy purposes

On Therapeutic Cancer Vaccines: Many uncontrolled RCC vaccine trials with seemingly impressive early phase clinical outcome data appear less impressive with the knowledge that some patients with metastatic RCC can have stable disease for long periods despite not receiving systemic therapy , and that partial and complete spontaneous regressions can occur in this group.