David A. Braun, MD, PhD, physician at Dana-Farber Cancer Institute and instructor of medicine at Harvard Medical School, discusses unanswered questions regarding the utility of PD-1 blockade in advanced renal cell carcinoma (RCC).

PD-1 inhibitors have transformed the treatment of patients with advanced RCC, says Braun; however, not all patients will experience durable clinical benefit. Going forward, a better understanding of the determinants of response, as well as the mechanisms of resistance, is of critical importance.

As opposed to melanoma and non­–small cell lung cancer, kidney cancer has a modest mutational burden but a robust CD8 T-cell infiltration. Therefore, the typical “hot” versus “cold” paradigm does not apply.

Due to the unmet need in the space, future research endeavors will focus on immune and genomic determinants of response and resistance to PD-1 blockade, Braun concludes.