Nivolumab and ipilimumab in the treatment of metastatic renal cell carcinoma. Report of two patients

In recent years new therapies have emerged for the management of metastatic renal cell carcinoma, from agents directed to the inhibition of the vascular endothelial growth factor (VEGF) pathway and mammalian target of rapamycin (mTOR) to novel immunotherapy agents targeting immune checkpoint inhibitors. Such is the case with nivolumab, a fully human monoclonal IgG4 antibody directed to block the interaction between PD-1 and PD 1 and 2 ligands, thus avoiding T-cell inhibition by tumor cells. We report two patients with metastatic renal cell carcinoma (mRCC) treated at the University Cancer Center at a tertiary level teaching hospital in Northeastern Mexico with nivolumab and ipilimumab, an anti-cytotoxic T-lymphocyte-associated antigen (CTLA-4) antibody directed to block the interaction between the B-7 family of molecules (CD80-D86) on antigen presenting cells and CTLA-4 expressed by T cells, which inhibits T-cell proliferation and function when triggered.