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Intrinsic immune alterations in renal cell carcinoma and emerging immunotherapeutic approaches

机译：肾细胞癌的内在免疫改变和新兴的免疫治疗方法

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Introduction: Individuals affected by kidney cancer present a variety of immune abnormalities including cellular immune dysfunction, cytokine alterations and antigen presentation defects. On the other hand, spontaneous remissions are seen in up to 4% of renal cell carcinoma (RCC) patients and they are thought to occur via immune mechanisms. Areas covered: The authors comprehensively review the immune abnormalities in RCC patient and describe the kidney cancer immunotherapy candidates that are most advanced in their clinical development. Most relevant publications were identified through searching the PubMed database; the obtained information was thoroughly analyzed and synthesized. Expert opinion: As cure in advanced RCC cannot be accomplished with the current therapy standards such as tyrosine kinase inhibitors and mammalian target of rapamycin inhibitors, new treatment strategies are being sought. Enhancing the immune system represents an appealing avenue for kidney cancer therapy. Disappointingly, high-dose interleukin-2 and interferon-α cause severe toxicity and produce a questionable clinical benefit. The authors postulate that the 'durable responses' seen with these agents in only a handful of RCC patients represent spontaneous remissions. Promising immune strategies in RCC such as anti-cytotoxic T-lymphocyte-associated protein antibodies, anti-programmed cell death 1 (PD1)/PD1 ligand and tumor vaccines may expand the existing options for kidney cancer in future years.
机译：简介：受肾癌影响的个体表现出多种免疫异常，包括细胞免疫功能障碍，细胞因子改变和抗原呈递缺陷。另一方面，在多达4％的肾细胞癌（RCC）患者中发现自发缓解，并且认为它们是通过免疫机制发生的。涵盖的领域：作者全面审查了RCC患者的免疫异常，并描述了在临床开发中最先进的肾癌免疫疗法候选药物。通过搜索PubMed数据库确定了最相关的出版物;对获得的信息进行了彻底的分析和综合。专家意见：由于无法通过当前的治疗标准（例如酪氨酸激酶抑制剂和雷帕霉素抑制剂的哺乳动物靶标）完成晚期RCC的治愈，因此正在寻求新的治疗策略。增强免疫系统代表了肾癌治疗的诱人途径。令人失望的是，大剂量的白介素2和干扰素-α会引起严重的毒性，并产生可疑的临床益处。作者推测，只有少数RCC患者在这些药物上看到的“持久反应”代表自发缓解。 RCC中有希望的免疫策略，例如抗细胞毒性T淋巴细胞相关蛋白抗体，抗程序性细胞死亡1（PD1）/ PD1配体和肿瘤疫苗，可能会在未来几年中扩大肾脏癌的现有选择范围。

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