At the American Urological Association’s Annual Meeting in San Diego this week, Dr Harshman spoke about treating renal cell carcinoma (RCC) before and after surgery with immunotherapy. Although results from the EVEREST trial and others are eagerly anticipated, there has been no major success using adjuvant therapies (treatment after surgery) in kidney cancer to date.

The argument to move treatment with PD-1 inhibitors earlier in the disease process is three-fold: (1) the durability of response can be long lasting; (2) continued response or disease stabilisation occurs even off therapy (so-called “memory response”); and (3) the overall tolerability as monotherapy is high making it a good potential partner compound with other agents.

Dr Harshman closed by suggesting before surgery priming with a PD-1 inhibitor (neoadjuvant therapy), surgery, and adjuvant therapy. She again reiterated earlier remarks about a complex, dynamic interplay between the tumour and the immune system. Overall, there is great hope and promise for improving care in patients with advanced renal cell carcinoma using new immunotherapeutic approaches.

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