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Renal Cancer Immunotherapy

Renal Cancer Immunotherapy. Walter Stadler. Renal cancer natural history. International prognostic model. Manola J et al. Clin Cancer Res 2011;17:5443-5450. Treatment: HD IL2. Cytokine Working Group trial HD IL2 vs sc IL2/IFNA HD IL2: 600,000 IU/kg q8 o x 14 doses

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Renal Cancer Immunotherapy

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  1. Renal Cancer Immunotherapy Walter Stadler

  2. Renal cancer natural history

  3. International prognostic model Manola J et al. Clin Cancer Res 2011;17:5443-5450

  4. Treatment: HD IL2 Cytokine Working Group trial HD IL2 vs sc IL2/IFNA • HD IL2: 600,000 IU/kg q8o x 14 doses • sc IL2/IFNA: 5 x 106 IU/m2 4d/wk IL2; 5 x106 IU/m2 2d/wk Selection criteria • Non-clear cell have minimal to no benefit • Suggestion that post-VEGFR TKI treatment has higher toxicity and lower efficacy

  5. Nivolumab (anti-PD1) in renal cancer *One CR. • Phase 3 vs everolimus in progress • Multiple PD1 pathway inhibitor trials in progress

  6. MPDL3280A Phase 1a (anti-PDL1) * 1 patient with unknown histology. Includes sarcomatoid and papillary RCC. All patients first dosed prior to August 1, 2012; data cutoff February 1, 2013. ORR includes unconfirmed PR/CR and confirmed PR/CR. Cho, et al, ASCO 2013

  7. Peptide vaccine IMA901 multi-peptide • 10 different tumor-associated • Not normal tissue • In-vitro immunogenic • HLA-A*02 restricted • Pharmaceutical grade Sunitinib IMA901 + GM-CSF 1st cycle with cyclophosphamide Metastatic disease HLA-A*02 positive No prior therapy N = 330 Overall Survival Renal Cancer|

  8. Dendritic Cell Therapy: AGS-003 RNA isolated from tumor cells Loaded on dendritic cells isolated through leukapheresis Administered intradermal Sunitinib + AGS-003 Metastatic disease No prior therapy Cytoreductive nephrectomy N = 450 Overall Survival Renal Cancer|

  9. RCC Immunotherapy Conclusions Has always been considered an “immunotherapy responsive tumor HD-IL2 leads to rare sustained complete responses PD1 pathway inhibitors are promising Other immunotherapies are being investigated Renal Cancer|

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