12/31/2022 0 Comments Age progression tf![]() Along with the research related to tumor immunology, the characteristics of tumor microenvironment (TME) in ccRCC have been identified by researchers, which consists of cancer cells, endothelial cells, myofibroblasts, fibroblasts, tumor-infiltrating immune cells, and extracellular matrix ( 10). Evidence suggests that immune regulatory mechanisms carry importance in tumorigenesis and cancer development. These ICIs can improve the OS of patients with metastatic renal cell carcinoma (mRCC) and metastatic urothelial carcinoma ( 9). The past few years have seen the emergence of immune checkpoint inhibitors (ICIs) which act by blocking the programmed cell death receptor 1 (PD-1) pathway. Tumors can exacerbate these immunosuppressive pathways, creating a tolerable microenvironment. Internal control of immune cell activation is mediated through stimulation of effector cells and related inhibitory receptors, whereas external control is mediated through the secretion of cells or inhibitors. This delicate balance is maintained through internal or external immune regulatory mechanisms. Studies have shown that maintaining the balance between timely and effective immunity and a lasting immune response is essential for immune defense ( 8). Cancer immunotherapy has always been the main driving force of personalized medicine. Researchers have gradually come to recognize the key role of immunoregulation in cancer ( 7). However, no reliable biomarkers to predict the prognosis of ccRCC have been discovered ( 4, 5), nor have there been any major breakthroughs in treatment for the disease in the past 20 years ( 6). In Europe, there are an estimated around seventy thousand new cases of clear cell renal cell carcinoma (ccRCC) and around thirty thousand related deaths each year ( 2, 3). Despite new targeted therapies having improved progression-free survival (PFS) and overall survival (OS) for patients with early-stage RCC, for those with stage IV disease, the 5-year survival rate remains below 10%, and 50% of patients survive for less than 1 year ( 1). Renal cell carcinoma (RCC) is the most common of all primary malignant kidney tumors in adults and includes the “classical” or “eosinophilic” variant of chromophobe RCC.
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