Cytoreductive nephrectomy (CN) may reduce the risk for early death among patients with metastatic renal cell carcinoma (mRCC) receiving immune checkpoint inhibitors, investigators reported at the ASCO Genitourinary Cancers Symposium 2022.
Using 2015-2018 data from the National Cancer Database, investigators identified 4369 adults with mRCC who received immune checkpoint inhibitors (ICI). Of these, 1589 (36.4%) also underwent CN. Large primary tumors (T4) and clinically node-negative status (cN0) were significantly associated with 1.5- and 1.6-fold increased odds of CN, respectively. Among the CN group, 85.3% received upfront surgery and 13.8% received prior systemic therapy.
Overall survival at 1 year was significantly higher in the CN vs ICI only group: 66.8% vs 33.2%, Stuthi Perimbeti, MBBS, MPH, of Roswell Park Comprehensive Cancer Center, Buffalo, New York, reported on behalf of her team. On multivariate analysis, CN independently predicted a 47% reduced risk for all-cause mortality.
“Our findings suggest that despite recent advances in systemic therapies for mRCC, CN retains an important role in carefully selected patients,” Dr Perimbeti and colleagues concluded in their study abstract.
Other study results showed that the group aged 51-65 years had a 39% lower risk for mortality compared with the group aged 18-35 years.
Black vs White adults, patients with 2 comorbidities vs none, and individuals with a lower median income (less than $30K vs more than $46K annually) had significant 24%, 24%, and 30% increased risks for death, respectively.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Perimbeti S, Jiang C, Deng L, et al. Impact of cytoreductive nephrectomy (CN) on survival in metastatic renal cell cancer (mRCC) treated with immune checkpoint inhibitors (ICI). Paper presented at: ASCO Genitourinary Cancers Symposium; February 17-19, 2022. Abstract 359.