ABSTRACT

Various treatments have been considered as the cornerstone for the management of patients with metastatic renal cell carcinoma (mRCC) over the past two decades. Currently, immunotherapy is a promising clue in the landscape of frontline treatment of mRCC. Immune checkpoint inhibitors (ICIs), which constitute a standard therapy in pretreated mRCC patients, are emerging as possible earlier treatment’s strategy in mRCC. Otherwise, antiangiogenetics are well established as a backbone therapy for mRCC, and research is now focused on development of innovative tyrosine kinase inhibitors (TKIs). Frontline combination with ICIs as well as strategies including both TKIs and immunotherapy demonstrated to significantly improve outcomes compared to single-agent antiangiogenetics. Nonetheless, a considerable proportion of patients shows primary resistance to ICIs and new approaches are currently emerging to resolve this important unmet need. Morover, several treatment strategies combining different mechanisms of action or targeting immune escape pathways are rising with the objective of improving response rates and patient’s outcomes. This review summarizes current immunotherapeutic agents approved for mRCC.