Cytoreductive nephrectomy (CN) without targeted therapy (TT) for metastatic renal cell carcinoma is associated with better survival compared with CN plus targeted therapy, according to “real-world” data presented at the Canadian Urological Association’s 74th Annual Meeting in Quebec City. TT alone is associated with increased risk of death.

Using the Canadian Kidney Cancer information system database, a team led by Lori A. Wood, MD, of Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia, identified 813 patients diagnosed with metastatic renal cell carcinoma after January 2011. They stratified patients into 4 groups based on their treatment: CN without TT (202 patients), CN followed by TT (383 patients), TT followed by CN (78 patients), and TT alone (150 patients).

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The median time between CN and TT initiation and between TT initiation and CN was 3 and 5 months, respectively, with a median TT duration of 5 and 7 months, respectively.


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The median overall survival for patients undergoing CN without TT, CN with TT, and TT alone was not reached, 37 months, and 13 months, respectively.

Compared with patients in the CN before and after TT group, CN without TT was associated with a significant 43% decreased risk of death, whereas targeted therapy alone was associated with a significant 2.1 times increased risk of death.

Undergoing metastasectomy and clear-cell histology were associated with 49% and 31% decreased risk of death, respectively.

Reference

Dragomir A, Nazha S, Tanguay S, et al. Outcomes of cytoreductive (CN) in metastatic renal cell carcinoma (mRCC) patients using real-world data from Canadian hospital centres. Presented at the Canadian Urological Association 74th Annual Meeting in Quebec City. Poster MP-9.10.

https://2019.cua.events/mobis/lecture/216