|The following article features coverage from the 2020 Genitourinary Cancers Symposium meeting. Click here to read more of Renal and Urology News’ conference coverage.|
SAN FRANCISCO—Although cytoreductive nephrectomy (CN) improved overall survival for patients with metastatic renal cell carcinoma (mRCC) in the interferon era (2004-2005), CN is not associated with better survival in the immune checkpoint inhibitor era (2013-2015), Joseph Miccio, MD, of the Yale School of Medicine in New Haven, CT, reported at the 2020 Genitourinary Cancers Symposium.
Use of immunotherapy declined by 65% during 2005 to 2006, then remained low (rising 11% from 2006-2012), and then increased by 93% from 2012 to 2013 (start of the immune checkpoint inhibitor era), he explained.
Among 1232 mRCC patients (median age 59 years) treated with immunotherapy (but not tyrosine kinase inhibitors) during 2004-2015, a greater proportion of patients treated with immune checkpoint inhibitors rather than interferon underwent CN, according to the National Cancer Database (37% vs 30%, respectively). In multivariable Cox regression models, CN was significantly associated with a 38% reduced risk for mortality during the interferon era, but a nonsignificant 18% reduced risk in the immune checkpoint era.
“Cytoreductive nephrectomy was not independently associated with improved survival for patients with metastatic renal cell carcinoma receiving immunotherapy in the immune checkpoint inhibitor era,” Dr Miccio told Renal & Urology News. “Given the retrospective nature of this analysis, these results are hypothesis-generating, and suggest the need for prospective re-evaluation of the role of cytoreductive nephrectomy and its timing with immune checkpoint inhibitor therapy in patients with metastatic renal cell carcinoma.”
In this study, 90% of CNs were performed before immunotherapy initiation in the immune checkpoint inhibitor era. The timing of surgery was not recorded in the interferon era.
Read more of our coverage of the 2020 Genitourinary Cancers Symposium by visiting the conference page.
Miccio JA, Ma S-J, Oladeru OT, et al. Association of cytoreductive nephrectomy and survival in the immune checkpoint inhibitor era. Presented at the 2020 Genitourinary Cancers Symposium held February 13 to 15 in San Francisco. Poster and abstract 748.