Immunotherapy for renal cell carcinoma: the differences from melanoma

Abstract

Recently, the immune checkpoint inhibitors (ICI) have developed significant improvement of clinical outcomes in various types of cancer, including melanoma, lung cancer, renal cell carcinoma (RCC), and so on. On the other hand, less obvious improvement was observed in some types of cancer such as prostate cancer and breast cancer. Why does this difference arise? One reason is the difference of tumor mutational burden in each cancer. The increasing mutational burden is generally associated with good response to ICI. However, RCC is not the type of cancer with high mutational burden like as melanoma and lung cancer. I review the current possibility to explain this discrepancy. Another reason could be the difference mechanisms of resistance against ICI between cancer types. I also review the perspectives about the resistant mechanisms of ICIs in Genitourinary cancer. Additionally, recent meta-analyses demonstrated the difference of frequency of immune-related adverse events between cancer types. I also review about this difference.