Immunotherapy in Advanced Renal Cancer — Is Cure Possible?

Treatment for advanced renal-cell carcinoma has traced a remarkable arc during the past 25 years. In the 1990s, options included interferon, interleukin-2, megestrol, and 5-fluorouracil chemotherapy.1 Although a small proportion of patients had durable regression of renal-cell carcinoma with interleukin-2,2 no randomized, controlled clinical trials showed a survival benefit with any therapy in that era. Knowledge about von Hippel–Lindau gene mutations in renal-cell carcinoma and the downstream up-regulation of hypoxia-inducible factors led to insights about how these pathways influence angiogenesis. This led to the development of tyrosine kinase inhibitors (TKIs) and mammalian target of rapamycin (mTOR) inhibitors of multiple receptors . . .