Own experience of using combination therapy in the first line of treatment of metastatic renal cell carcinoma

Abstract

Renal cell carcinoma is one of the most common diseases in oncourology. The leading morphological variation of renal cell carcinoma today is the light-cell subtype, which is determined in 80% of cases. Despite the intensity of diagnostic methods, almost 1/3 of patients with kidney cancer have distant metastases during initial examination, which causes extremely high mortality rates from this oncopathology. Standard chemotherapy schemes with the inclusion of fluoropyrimidines and antitumor antibiotics, cytokine therapy using interleukin-2 and interferon α only slightly prolonged the life of patients, while causing pronounced toxic-anemic adverse events. The appearance of tyrosine kinase inhibitors has allowed us to obtain really significant results in the treatment of metastatic renal cell carcinoma. The next step in the treatment of renal cell carcinoma was the registration by the US FDA in April 2018 of a combination of immuno-oncological drugs ipilimumab and nivolumab for the treatment of metastatic renal cell carcinoma. Afterwards, combinations of immune checkpoint inhibitors with targeted drugs were registered, which not only significantly increased the life expectancy of patients, but also reduced the incidence of adverse events of antitumor therapy. This article provides clinical examples demonstrating the effectiveness of the combination of pembrolizumab and axitinib in the treatment of patients with metastatic renal cell carcinoma.