Next Article in Journal
A New Tumor Burden Score and Albumin–Bilirubin Grade-Based Prognostic Model for Hepatocellular Carcinoma
Previous Article in Journal
Targeting Tumor Glycans for Cancer Therapy: Successes, Limitations, and Perspectives
Review

Combination of Anti-Angiogenics and Checkpoint Inhibitors for Renal Cell Carcinoma: Is the Whole Greater Than the Sum of Its Parts?

1
Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1374, Houston, TX 77030, USA
2
Department of Oncology, School of Medicine, Georgetown University, Washington, DC 20007, USA
3
Georgetown Lombardi Comprehensive Cancer Center, Washington, DC 20057, USA
4
Department of Medical Oncology, Guy’s and St Thomas’ Hospitals, London SE1 9RT, UK
5
Sarah Cannon Research Institute, London W1G 6AD, UK
6
Centre for Personalised Nanomedicine, The University of Queensland, Brisbane, QLD 4072, Australia
*
Author to whom correspondence should be addressed.
Academic Editor: Ke Chen
Cancers 2022, 14(3), 644; https://doi.org/10.3390/cancers14030644
Received: 23 December 2021 / Revised: 21 January 2022 / Accepted: 23 January 2022 / Published: 27 January 2022
Checkpoint inhibitors and anti-angiogenic therapies are treatments that slow the progression of renal cell carcinoma, the most common type of kidney cancer. Checkpoint inhibitors and anti-angiogenic therapies work in different ways. Checkpoint inhibitors help to prevent tumors from hiding from the body’s immune system, while anti-angiogenic therapies slow the development of blood vessels that tumours need to help them to grow. Studies have shown that treatment with combination checkpoint inhibitor plus anti-angiogenic therapy can achieve better outcomes for patients with renal cell carcinoma than treatment with anti-angiogenic therapy alone. In this review, we consider how combination checkpoint inhibitor plus anti-angiogenic therapy works, and we review the current literature to identify evidence to inform clinicians as to the most effective way to use these different types of drugs, either one after the other, or together, for maximum patient benefit.
Anti-angiogenic agents, such as vascular endothelial growth factor (VEGF) receptor tyrosine kinase inhibitors and anti-VEGF antibodies, and immune checkpoint inhibitors (CPIs) are standard treatments for advanced renal cell carcinoma (aRCC). In the past, these agents were administered as sequential monotherapies. Recently, combinations of anti-angiogenic agents and CPIs have been approved for the treatment of aRCC, based on evidence that they provide superior efficacy when compared with sunitinib monotherapy. Here we explore the possible mechanisms of action of these combinations, including a review of relevant preclinical data and clinical evidence in patients with aRCC. We also ask whether the benefit is additive or synergistic, and, thus, whether concomitant administration is preferred over sequential monotherapy. Further research is needed to understand how combinations of anti-angiogenic agents with CPIs compare with CPI monotherapy or combination therapy (e.g., nivolumab and ipilimumab), and whether the long-term benefit observed in a subset of patients treated with CPI combinations will also be realised in patients treated with an anti-angiogenic therapy and a CPI. Additional research is also needed to establish whether other elements of the tumour microenvironment also need to be targeted to optimise treatment efficacy, and to identify biomarkers of response to inform personalised treatment using combination therapies. View Full-Text
Keywords: vascular endothelial growth factor; immune checkpoint inhibitors; advanced renal cell carcinoma; combination therapy vascular endothelial growth factor; immune checkpoint inhibitors; advanced renal cell carcinoma; combination therapy
Show Figures

Figure 1

MDPI and ACS Style

Jonasch, E.; Atkins, M.B.; Chowdhury, S.; Mainwaring, P. Combination of Anti-Angiogenics and Checkpoint Inhibitors for Renal Cell Carcinoma: Is the Whole Greater Than the Sum of Its Parts? Cancers 2022, 14, 644. https://doi.org/10.3390/cancers14030644

AMA Style

Jonasch E, Atkins MB, Chowdhury S, Mainwaring P. Combination of Anti-Angiogenics and Checkpoint Inhibitors for Renal Cell Carcinoma: Is the Whole Greater Than the Sum of Its Parts? Cancers. 2022; 14(3):644. https://doi.org/10.3390/cancers14030644

Chicago/Turabian Style

Jonasch, Eric, Michael B. Atkins, Simon Chowdhury, and Paul Mainwaring. 2022. "Combination of Anti-Angiogenics and Checkpoint Inhibitors for Renal Cell Carcinoma: Is the Whole Greater Than the Sum of Its Parts?" Cancers 14, no. 3: 644. https://doi.org/10.3390/cancers14030644

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop