NcXHF

WEINSTOCK AND MCDERMOTT
metastatic RCC sites in 15% (5 of 33) of patients, suggesting
that differential PD-L1 expression profıles between primary
and metastatic lesions may contribute to the heterogeneity of
responsiveness to anti-PD-1/PD-L1 targeted therapies. 109 In
the setting of such heterogeneous PD-L1 expression, it is
likely that the most useful models for prediction of response
to immunotherapy will integrate PD-L1 status with other
clinical, pathologic, molecular, and cytogenetic variables.
These may include PD-L2 status, 110 gene expression profıling,
111 and/or clinical characteristics such as the Memorial
Sloan Kettering Cancer Center (MSKCC) risk score 96 or International
Metastatic RCC Database Consortium (IDMC or
Heng) criteria. 112 Development of comprehensive predictive
models for immunotherapy in mRCC is currently an active
area of investigation.
CONCLUSION
Novel immunotherapies have produced encouraging initial
results in the treatment of metastatic RCC; however, these
agents are unlikely to be effective as monotherapy in the majority
of patients. At present, intensive clinical study is focused
on devising combinations of therapies and developing
more accurate predictive biomarker models in an effort to
improve clinical outcomes.
Disclosures of Potential Conflicts of Interest
Relationships are considered self-held and compensated unless otherwise noted. Relationships marked “L” indicate leadership positions. Relationships marked “I” are those held by an immediate
family member; those marked “B” are held by the author and an immediate family member. Institutional relationships are marked “Inst.” Relationships marked “U” are uncompensated.
Employment: None. Leadership Position: None. Stock or Other Ownership Interests: None. Honoraria: None. Consulting or Advisory Role: David F.
McDermott, BMS, Genentech/Roche, Merck, Pfizer. Speakers’ Bureau: None. Research Funding: David F. McDermott, Prometheus. Patents, Royalties, or
Other Intellectual Property: None. Expert Testimony: None. Travel, Accommodations, Expenses: None. Other Relationships: None.
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