Evidence map›Paper›PMID 37693729›Full record

ArticleEuropean urology open science2023

Indications and Outcomes for Deferred Cytoreductive Nephrectomy Following Immune Checkpoint Inhibitor Combination Therapy: Can Systemic Therapy be Withdrawn in Patients with No Evidence of Disease?

Elisabeth E Fransen van de Putte, Luna van den Brink, Mohamed A Mansour, Johannes C van der Mijn, Sofie Wilgenhof, Johannes V van Thienen, John B A G Haanen, Ekaterini Boleti, Thomas Powles, Patricia J Zondervan and 2 more

Open access · goldAbstract read
In one paragraph

Article in European urology open science, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
3.9field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 15 citations in OpenAlex.

  1. Article
  2. Article
  3. 2024 CUA-KCRNC Expert Report: Management of non-clear cell renal cell carcinoma.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2024
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 2 countries.

Elisabeth E Fransen van de PutteDepartment of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Luna van den BrinkDepartment of Urology, Amsterdam Medical University Centre, Amsterdam, The Netherlands.
Mohamed A MansourDepartment of Urology, Specialist Centre for Kidney Cancer, The Royal Free London NHS Foundation Trust, London, UK.
Johannes C van der MijnDepartment of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Sofie WilgenhofDepartment of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Johannes V van ThienenDepartment of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
John B A G HaanenDepartment of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Ekaterini BoletiDepartment of Medical Oncology, Specialist Centre for Kidney Cancer, The Royal Free London NHS Foundation Trust, London, UK.
Thomas PowlesDepartment of Medical Oncology, Specialist Centre for Kidney Cancer, The Royal Free London NHS Foundation Trust, London, UK.
Patricia J ZondervanDepartment of Urology, Amsterdam Medical University Centre, Amsterdam, The Netherlands.
Niels M GraaflandDepartment of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Axel BexDepartment of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
The Netherlands Cancer Institute · NLRoyal Free London NHS Foundation Trust · GBUniversity of Amsterdam · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Upfront cytoreductive nephrectomy (CN) is no longer the standard of care for patients with metastastic renal cell carcinoma (mRCC) with intermediate or poor prognosis according to the International mRCC Database Consortium categories. Objective: To investigate indications for CN following first-line ipilimumab-nivolumab, and assess management and outcomes for patients achieving no evidence of disease (NED) after CN. Design setting and participants: This was a retrospective cohort study among 125 patients with synchronous mRCC who received ipilimumab-nivolumab treatment between March 2019 and June 2022 at four European centres. At one of the four centres, nivolumab was stopped following NED. Outcome measurements and statistical analysis: We measured complete response of metastases (mCR) according to Response Evaluation Criteria in Solid Tumours 1.1; near-complete response of mestastases (mnCR) was defined as a >80% reduction in cumulative metastatic volume. Treatment-free survival (TFS), disease-free survival (DFS), progression-free survival (PFS), and cancer-specific survival (CSS) were determined. Results and limitations: At median follow-up of 25 mo, 23/125 patients (18%) had undergone deferred CN. Of 26 patients (21%) with mCR or mnCR, 19 (73%) underwent CN to achieve NED, of whom 11 (58%) discontinued nivolumab, with median TFS of 21 mo. For patients who continued ( Conclusions: CN can result in NED, durable DFS, and substantial time off systemic therapy. More collaborative data are required to ascertain the benefits of treatment discontinuation versus oncologic safety. Patient summary: In our study using real-world data, 18% of patients treated with immunotherapy underwent deferred kidney surgery. The majority were free of disease after 3 years. Half of the patients who stopped immunotherapy after surgery have been off therapy for 21 months or longer. Larger studies are needed to investigate the effect of kidney surgery and discontinuation of immunotherapy on survival.

Indexed as

CytoreductiveIndicationsIpilimumabNephrectomyNivolumab

Identifiers

PMID37693729
PMCPMC10485779
OpenAlexW4385595369

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.