Keyword: Immunotherapy
2 results found.
Congress Abstract
Oncology, Nuclear Medicine and Transplantology, 2(3, Suppl. 1), 2026, onmt_A30, https://doi.org/10.63946/onmt/19307
ABSTRACT:
Background: The introduction of targeted therapy and immune checkpoint inhibitors has significantly improved treatment outcomes in patients with locally advanced and metastatic renal cell carcinoma (mRCC). However, tumor heterogeneity and the development of alternative signaling pathways may contribute to treatment resistance, emphasizing the need for effective combination strategies.
Objective: To evaluate the efficacy of contemporary immunotherapy-based combinations in the first-line treatment of metastatic renal cell carcinoma and identify clinical factors relevant to treatment selection.
Materials and Methods: Published data from randomized phase III studies of first-line systemic therapy for advanced and metastatic renal cell carcinoma were analyzed. Particular attention was given to nivolumab plus ipilimumab and lenvatinib plus pembrolizumab compared with sunitinib. Treatment efficacy was assessed using progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and outcomes according to International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk groups.
Results: In the CLEAR trial, lenvatinib plus pembrolizumab significantly prolonged median PFS compared with sunitinib (23.9 vs 9.2 months) and improved overall survival. In patients with intermediate/poor IMDC risk, median PFS was 22.1 months with lenvatinib plus pembrolizumab versus 5.9 months with sunitinib, while ORR was 72.4% versus 28.8%, respectively. Long-term results of the CheckMate 214 trial demonstrated a sustained survival benefit with nivolumab plus ipilimumab compared with sunitinib. The final analysis after a median follow-up of 9.3 years showed an OS hazard ratio of 0.71 in the intention-to-treat population and 0.69 in patients with intermediate/poor IMDC risk. Durable responses were maintained across long-term follow-up.
Conclusions: Immunotherapy-based combinations have substantially improved the treatment of metastatic renal cell carcinoma. Lenvatinib plus pembrolizumab provides significant improvements in PFS and objective response compared with sunitinib, while nivolumab plus ipilimumab demonstrates durable long-term survival benefits. Selection of first-line therapy should consider IMDC risk group, tumor burden, metastatic sites, clinical condition, histological characteristics, and individual patient factors.
Objective: To evaluate the efficacy of contemporary immunotherapy-based combinations in the first-line treatment of metastatic renal cell carcinoma and identify clinical factors relevant to treatment selection.
Materials and Methods: Published data from randomized phase III studies of first-line systemic therapy for advanced and metastatic renal cell carcinoma were analyzed. Particular attention was given to nivolumab plus ipilimumab and lenvatinib plus pembrolizumab compared with sunitinib. Treatment efficacy was assessed using progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and outcomes according to International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk groups.
Results: In the CLEAR trial, lenvatinib plus pembrolizumab significantly prolonged median PFS compared with sunitinib (23.9 vs 9.2 months) and improved overall survival. In patients with intermediate/poor IMDC risk, median PFS was 22.1 months with lenvatinib plus pembrolizumab versus 5.9 months with sunitinib, while ORR was 72.4% versus 28.8%, respectively. Long-term results of the CheckMate 214 trial demonstrated a sustained survival benefit with nivolumab plus ipilimumab compared with sunitinib. The final analysis after a median follow-up of 9.3 years showed an OS hazard ratio of 0.71 in the intention-to-treat population and 0.69 in patients with intermediate/poor IMDC risk. Durable responses were maintained across long-term follow-up.
Conclusions: Immunotherapy-based combinations have substantially improved the treatment of metastatic renal cell carcinoma. Lenvatinib plus pembrolizumab provides significant improvements in PFS and objective response compared with sunitinib, while nivolumab plus ipilimumab demonstrates durable long-term survival benefits. Selection of first-line therapy should consider IMDC risk group, tumor burden, metastatic sites, clinical condition, histological characteristics, and individual patient factors.
Review Article
Oncology, Nuclear Medicine and Transplantology, 2(2), 2026, onmt020, https://doi.org/10.63946/onmt/18860
ABSTRACT:
Prostate cancer still remains one of the most common cancers in men worldwide, and it is a great therapeutic challenge, especially in the field of immunotherapeutics. The tumour microenvironment (TME) is immunologically “cold” in prostate cancer, and influenced by intrinsic molecular characteristics of the disease such as androgen receptor (AR) signalling, PTEN loss, and lineage plasticity towards neuroendocrine prostate cancer (NEPC). Together, these aspects inhibit antigen presentation, block the entry of cytotoxic T cells and help to establish spatially organised immunosuppressive niches, providing a rational explanation for the clinical variability and partial efficacy of immune-based therapies.
Traditional bulk genomic approaches have provided important insights into tumour biology but are unable to capture the cellular and spatial complexity of tumour–immune interactions. These developments have been spurred by recent advancements in single-cell RNA sequencing (scRNA-seq) and spatial transcriptomics, which allow to detect individual cell subpopulations within intact tumour tissues, such as exhausted T cells co-expressing PD-1, TIM-3, LAG-3 and TIGIT, immunosuppressive SPP1+ macrophages and various cancer-associated fibroblast subpopulations. These technologies have identified specific immune exclusion sites, stromal–epithelial immune silencing barriers, and therapeutic resistance and immune evasion regulatory programs in the context of prostate cancer specifically.
However, there are still many technical challenges that need to be overcome, such as the lack of patient samples and their demographic diversity, data integration, lack of spatial characterisation of bone metastases and difficulties in clinical translation. Comprehensive multi-omics atlases, AI-driven spatial pattern recognition, functional validation of potential targets and prospective clinical trials based on biomarkers are all important areas for future research. They show significant potential for the creation of better, personalized immunotherapeutic treatment for prostate cancer.
Traditional bulk genomic approaches have provided important insights into tumour biology but are unable to capture the cellular and spatial complexity of tumour–immune interactions. These developments have been spurred by recent advancements in single-cell RNA sequencing (scRNA-seq) and spatial transcriptomics, which allow to detect individual cell subpopulations within intact tumour tissues, such as exhausted T cells co-expressing PD-1, TIM-3, LAG-3 and TIGIT, immunosuppressive SPP1+ macrophages and various cancer-associated fibroblast subpopulations. These technologies have identified specific immune exclusion sites, stromal–epithelial immune silencing barriers, and therapeutic resistance and immune evasion regulatory programs in the context of prostate cancer specifically.
However, there are still many technical challenges that need to be overcome, such as the lack of patient samples and their demographic diversity, data integration, lack of spatial characterisation of bone metastases and difficulties in clinical translation. Comprehensive multi-omics atlases, AI-driven spatial pattern recognition, functional validation of potential targets and prospective clinical trials based on biomarkers are all important areas for future research. They show significant potential for the creation of better, personalized immunotherapeutic treatment for prostate cancer.