[Immunotherapy in uropathology]

The algorithms for treatment of metastatic cancers are evolving due to positive results obtained with immunotherapy. Therapeutics approaches to stimulate the immune system have already been used in the treatment of kidney and bladder cancer, such as the administration of cytokines and BCG therapy, confirming the immunogenicity of these tumors. The aim of immunotherapies is not only to activate the immune system against tumor cells, but also to take into account the tumor-induced suppressive microenvironment, in particular by removing the anergy of T-cell lymphocytes, and by targeting the co-stimulation inhibitors molecules. Among the genito-urinary cancers, second-line clinical trials have clearly shown that kidney and bladder cancers are sensitive to the inhibition of PD-1/PD-L1 axis and have already achieved FDA approvals for some molecules. Numerous other clinical trials are underway, particularly in first-line treatment in bladder and renal cancers. Refractory testicular cancer could also benefit from these treatments. Other approaches using vaccine therapy especially in castration-resistant prostate cancer are also of interest. We will see, in this chapter dedicated to the urogenital cancers, the benefit of the immunotherapy by resituating it in the genetic and immunological context of each organ. We will also present briefly the therapeutic outlines and the place of biomarkers.

Annales de pathologie. 2017 Jan 19 [Epub ahead of print]

Virginie Verkarre, Hélène Roussel, Clémence Granier, Eric Tartour, Yves Allory

Service d'anatomie pathologique, hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France; Faculté de médecine, université Paris Descartes, 15, rue de l'École-de-Médecine, 75006 Paris, France. Electronic address: ., Service d'anatomie pathologique, hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France; Faculté de médecine, université Paris Descartes, 15, rue de l'École-de-Médecine, 75006 Paris, France; Unité Inserm U970, Paris Cardiovascular Research Center, PARCC, 56, rue Leblanc, 75015 Paris, France., Unité Inserm U970, Paris Cardiovascular Research Center, PARCC, 56, rue Leblanc, 75015 Paris, France., Faculté de médecine, université Paris Descartes, 15, rue de l'École-de-Médecine, 75006 Paris, France; Unité Inserm U970, Paris Cardiovascular Research Center, PARCC, 56, rue Leblanc, 75015 Paris, France; Service d'immunologie biologique, hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France., Service d'anatomie pathologique, hôpital Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94000 Créteil, France; Faculté de médecine, université Paris-Est Créteil Val de Marne (UPEC), 61, avenue du Général-de-Gaulle, 94000 Créteil, France.

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