Role of immune system in kidney cancer

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Almost all kidney cancers are associated to immune dysfunction. Among these, renal cell carcinoma (RCC) represents approximately 2% of malignancies that affect adults and for 90–95% of all kidney cancers. Recent evidences have collaborated to elucidate the mechanisms involved in the development of this disease. In this view, dysfunctional neutrophil migration, as well as T lymphocyte-DC (dendritic cell) cross talk, DC maturation, immune cell metabolism, and reactivity and abnormal expression of cytokines and chemokines and their receptors have been highlighted in RCC and stroma cells. A rational development of novel therapies to recover antitumor activity of immune system is closely related to the understanding of the complex interactions between immune system and tumor. Some insights have been reached and immunomodulatory molecules, such as interleukin-2 (IL-2) and IFN-α, immune checkpoint inhibitors, and chemokines antagonists have shown clinical efficacy. In this chapter, we overview the essential role of innate and adaptive immune response in RCC and discuss drugs approved or in development for its treatment.
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