The results of a trial looking at immunotherapy treatment with and without cytoreductive nephrectomy were presented at the 20th annual meeting of the Society of Urologic Oncology in Washington this week.
The study included 391 patients diagnosed with metastatic renal cell carcinoma (RCC) between 2015 and 2016 from the National Cancer Data Base (NCDB). Of these, 221 (56.5%) received both cytoreductive nephrectomy and immunotherapy and 170 (43.5%) received immunotherapy only. Of the 221 patients who received both treatments, 197 had cytoreductive nephrectomy prior to immunotherapy and 24 received immunotherapy prior to nephrectomy.
Patients who had both cytoreductive nephrectomy plus immunotherapy had a significant 77% decreased risk of death compared with the immunotherapy-only group. Immunotherapy given before nephrectomy resulted in smaller tumour size, lower tumour stage, Fuhrman grade, and tumour vascularity compared to nephrectomy before immunotherapy.
The researchers said, “……our findings support an oncologic role for CN [cytoreductive nephrectomy] in the modern IO [immunotherapy] era and provide preliminary evidence regarding the timing and safety of CN relative to IO administration. Prospective validation is indeed warranted.”