A novel personalized vaccine approach in combination with targeted therapy in advanced renal cell carcinoma

Resveratrol inhibits tumor progression by down-regulation of NLRP3 in renal cell carcinoma

Renal cell carcinoma (RCC) is one of the most common urologic malignant tumors. Current chemotherapy is not effective in RCC and results in some side effects. Resveratrol (RSV) has been reported to exert antitumor effects in some cancer cells; however the mechanism is not fully understood. Herein, we aimed to determine the anticancer effect of RSV on RCC and further explore the underlying molecular mechanism in this process. We found that RSV inhibited tumor cells proliferation, migration and invasion and increased apoptosis of RCC either in vivo or in vitro. RSV significantly down-regulated expressions of NLRP3 and its downstream genes. Inhibition of NLRP3 by NLRP3 small interfering RNA mimicked the effects of RSV on RCC cells. These results suggested that RSV could exert antitumor effect by depressing activity of NLRP3, and NLRP3 would be a promising clinical therapeutic strategy for RCC.

[Anti-cancer vaccines: What future in anti-cancer immunotherapy strategies?]

Tumor cells can be recognized by the immune system and in particular by cytotoxic CD8⁺T cells. From this observation was derived the concept that vaccination targeting these tumor-associated molecules was feasible. Preventive cancer vaccines targeting oncogenic papillomavirus or hepatitis B virus do exist and are efficient. They aim at preventing the introduction into the body of viruses that play a role in oncogenesis. To date, in the case of an already grown cancer, the anti-tumor vaccines have had no impact on the care of patients. These vaccines are gaining renewed interest, as new antigenic targets have emerged and have been incorporated into the design of vaccines, such as mutated antigens which appeared to be more immunogenic. Less editing cells than tumor cells in the tumor microenvironment, such as protumor endothelial cells or fibroblasts, could also be eliminated by cancer vaccines. New vaccine efficacy criteria have been identified, such as the need to induce intratumoral resident T lymphocytes thanks to the development of mucosal vaccination to amplify them. Finally, because of the immunosuppression of the tumor microenvironment and the expression of inhibitory receptors on CD8⁺T cells in the tumor, various therapeutic association strategies between the anti-cancer vaccines and molecules supporting these inhibitions are currently used in clinical development. Especially, the efficacy of antibodies against costimulatory inhibitory molecules (PD-1, PD-L1…) relies on the presence of pre-existing CD8⁺T cells occurring in 25-30% of cancer patients. For the 70% resistant patients, cancer vaccine may reprogram this tumor environment via the induction of intratumoral CD8⁺T cells which will very likely counteract this resistance to anti-PD-1/PD-L1 antibodies.

Exploiting natural anti-tumor immunity for metastatic renal cell carcinoma

Clinical observations of spontaneous disease regression in some renal cell carcinoma (RCC) patients implicate a role for tumor immunity in controlling this disease. Puzzling, however, are findings that high levels of tumor infiltrating lymphocytes (TIL) are common to RCC. Despite expression of activation markers by TILs, functional impairment of innate and adaptive immune cells has been consistently demonstrated contributing to the failure of the immune system to control RCC. Immunotherapy can overcome the immunosuppressive effects of the tumor and provide an opportunity for long-term disease free survival. Unfortunately, complete response rates remain sub-optimal indicating the effectiveness of immunotherapy remains limited by tumor-specific factors and/or cell types that inhibit antitumor immune responses. Here we discuss immunotherapies and the function of multiple immune system components to achieve an effective response. Understanding these complex interactions is essential to rationally develop novel therapies capable of renewing the immune system's ability to respond to these tumors.