Which medications in the drug class PD-1/PD-L1 Inhibitors are used in the treatment of Renal Cell Carcinoma?

Updated: Jun 08, 2020
  • Author: Kush Sachdeva, MD; Chief Editor: E Jason Abel, MD  more...
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Answer

PD-1/PD-L1 Inhibitors

Nivolumab (Opdivo)

Nivolumab is a monoclonal antibody to programmed cell death–1 protein (PD-1). PD-1 and related target PD-ligand 1 (PD-L1) are expressed on the surface of activated T cells under normal conditions. PD-L1/PD-1 interaction inhibits immune activation and reduces T-cell cytotoxic activity when bound. This negative feedback loop is essential for maintaining normal immune responses and limits T-cell activity to protect normal cells during chronic inflammation. Tumor cells may circumvent T-cell–mediated cytotoxicity by expressing PD-L1 on the tumor itself or on tumor-infiltrating immune cells, resulting in the inhibition of immune-mediated killing of tumor cells. Nivolumab monotherapy is indicated for patients with advanced RCC who have received prior anti-angiogenic therapy (eg, VEGF inhibitors). It is also indicated in combination with ipilimumab for patients with intermediate or poor risk, previously untreated advanced renal cell carcinoma.

Pembrolizumab (Keytruda)

Monoclonal antibody to programmed cell death-1 protein (PD-1); blocks interaction between PD-1 and its ligands, PD-L1 and PD-L2. Tumor cells may circumvent T-cell–mediated cytotoxicity by expressing PD-L1 on the tumor itself or on tumor-infiltrating immune cells, resulting in the inhibition of immune-mediated killing of tumor cells. It is indicated as first-line treatment of advanced RCC in combination with axitinib.

Avelumab (Bavencio)

Anti-PD-L1 IgG1 monoclonal antibody. Binding of PD-L1 to the PD-1 and B7.1 receptors found on T cells and antigen-presenting cells suppresses cytotoxic T-cell activity, T-cell proliferation, and cytokine production. It is indicated in combination with axitinib for first-line treatment of advanced RCC.


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