Trial Watch: Therapeutic vaccines in metastatic renal cell carcinoma

Despite the renaissance of cancer immunotherapy, no novel immunotherapy has been approved for the treatment of renal cell cancer (RCC) since the availability of recombinant cytokines (interleukin-2, interferon-α).

All vaccine trials have failed to meet their endpoints although they have highlighted potential predictive biomarkers (e.g., pre-existing immune response, hematological parameters, tumor burden). Recent advances in immunomodulatory therapies have prompted the study of combination treatments targeting the tumor immunosuppressive microenvironment consisting of regulatory T-cells (Treg), myeloid suppressor cells, and cytokines. Approaches under investigation are use of inhibitors to curb the overexpression of immune checkpoint ligands by tumor cells (e.g., anti-CTLA-4, anti-PD-1/PD-L1) and exploiting the immunomodulatory effects of anti-angiogenic agents that are the current standard of metastatic RCC care. Phase III trials are focusing on the possible synergy between therapeutic vaccines (e.g., IMA-901 and AGS-003) and anti-angiogenic agents.

Keywords:AGS-003; CAIX; IMA-901; Memorial Sloan Kettering Cancer Center; NK; Von Hippel Landau; anti-angiogenic agent; carbonic anhydrase IX; ccRCC; checkpoint inhibitor; clear cell renal cell carcinoma; CIK; cytokine induced killer; CTL; cytotoxic T-lymphocyte-associated protein 4; DC; cytotoxic T-lymphocyte; CTLA-4 ; dendritic cell; GM-CSF; granulocyte macrophage colony-stimulating factor; HGF; heat shock protein; IFN; hepatocyte growth factor; HLA; human leukocyte antigen; HSP; interferon; IL; interleukin; KIR; killer immunoglobin-like receptor; MDR; major histocompatibility complex; MSKCC; multidrug resistance protein; MDSC; myeloid derived suppressor cell; MHC; natural killer; ORR; overall response rate; OS; peripheral blood mononuclear cell; PD-1; phosphatase and tensin homolog; TAA; programmed cell death ligand 1; PTEN; programmed cell death protein 1; PD-L1; regulatory T-cell; TUMAP; renal cell carcinoma; therapeutic vaccine; toll-like receptor; Treg; tumor infiltrating lymphocyte; TLR; tumor-associated antigen; TIL; tumor-associated peptide; VEGF; vascular endothelial growth factor; VHL; verall survival; PBMC

Oncoimmunology. 2015 Mar 19;4(5):e1001236. eCollection 2015.

Combe P, de Guillebon E, Thibault C, Granier C, Tartour E, Oudard S.