New treatment options for renal cell carcinoma-efficacy and safety of immune checkpoint inhibitors

In addition to chemotherapy for advanced renal cell carcinoma (RCC), molecular targeted drugs such as tyrosine kinase inhibitors (TKI) and mTOR inhibitors have been clinically introduced, and they have contributed to improved progression free survival (PFS) and overall survival (OS). However, complete response over a long period are rarely obtained with these drugs, and there are many cases of recurrence and progression. The anti-PD-1 antibody nivolumab, an immune checkpoint inhibitor, has approved for the indication of "Unresectable or metastatic RCC" in Japan, based on the phase III study results for advanced RCC with previous TKI treatment. The nivolumab response indicates the possibility of a sustained treatment effect for a long period of time, but also suggests the tendency to take time to develop the effect. Regarding safety, immune-related adverse events (irAEs) with a profile that may be different from those of conventional drugs, and in addition to fully understanding these features, we need to be familiar with how to manage irAEs,.