Journal
FRONTIERS IN IMMUNOLOGY
Volume 12, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2021.653358
Keywords
clear cell renal cell carcinoma; tumor immune microenvironment; immunotherapy; targeted therapy; genomic characteristics
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Funding
- Natural Science Foundation of Guangdong Province [2019A1515010234]
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Immune checkpoint inhibitors are a first-line treatment option for ccRCC, but many patients do not respond to them, even with combination therapy. Studies have shown that the tumor immune microenvironment (TIME) plays a crucial role in the response to immunotherapy and targeted therapy in ccRCC patients, which can be influenced by targeted therapy and tumor genomic characteristics.
Immune checkpoint inhibitors (ICIs) are currently a first-line treatment option for clear cell renal cell carcinoma (ccRCC). However, recent clinical studies have shown that a large number of patients do not respond to ICIs. Moreover, only a few patients achieve a stable and durable response even with combination therapy based on ICIs. Available studies have concluded that the response to immunotherapy and targeted therapy in patients with ccRCC is affected by the tumor immune microenvironment (TIME), which can be manipulated by targeted therapy and tumor genomic characteristics. Therefore, an in-depth understanding of the dynamic nature of the TIME is important for improving the efficacy of immunotherapy or combination therapy in patients with advanced ccRCC. Here, we explore the possible mechanisms by which the TIME affects the efficacy of immunotherapy and targeted therapy, as well as the factors that drive dynamic changes in the TIME in ccRCC, including the immunomodulatory effect of targeted therapy and genomic changes. We also describe the progress on novel therapeutic modalities for advanced ccRCC based on the TIME. Overall, this review provides valuable information on the optimization of combination therapy and development of individualized therapy for advanced ccRCC.
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