ArticleClinical genitourinary cancer2024
Pathological Response and Outcomes in Patients With Metastatic Renal Cell Carcinoma (mRCC) Receiving Immunotherapy-Based Therapies and Undergoing Deferred Cytoreductive Nephrectomy (CN).
Article in Clinical genitourinary cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Curative-Intent Pancreatectomy for Pancreatic Metastasis From Renal Cell Carcinoma 30 Years After Nephrectomy Following Lenvatinib Plus Pembrolizumab Therapy: A Case Report.IJU case reports · 2026Article
- Article
- Long-term Real-world Survival Outcomes with Dual Immune Checkpoint Blockade in Synchronous Metastatic Renal Cell Carcinoma: Implications for the Design of Prospective Cytoreductive Nephrectomy Trials.European urology open science · 2026Article
- Immune checkpoint inhibitor therapy in metastatic renal cell carcinoma: tumour response and immune-related renal vasculitis following cytoreductive nephrectomy.Pathologica · 2025Article
- Clinical and pathological outcomes of deferred nephrectomy in patients with metastatic and locally advanced RCC after immune checkpoint inhibitors.The oncologist · 2025Article
- Navigating advanced renal cell carcinoma in the era of artificial intelligence.Cancer imaging : the official publication of the International Cancer Imaging Society · 2025Review
- A Review of Neoadjuvant Therapy for Localized and Locally Advanced Renal Cell Carcinoma.Cancers · 2025Review
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19 authors.
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Abstract
In this study we evaluated outcomes of patients with metastatic renal cell carcinoma who received immunotherapy before surgery. We found that receiving immunotherapy combinations before surgery can offer patients benefits in reducing tumor size and improving disease control.
backgroundImmunotherapy (IO) has improved outcomes for patients with metastatic renal cell carcinoma (mRCC). However, the timing of surgical intervention for cytoreductive nephrectomy (CN) is still controversial for this group of patients. PATIENTS AND
methodsWe identified patients with mRCC receiving IO-based therapies and undergoing CN. Patients were divided into 2 cohorts: those who underwent upfront CN and those who underwent deferred CN. Pathologic and radiographic features along with clinical outcomes were systematically collected. Comparisons were performed using Chi-square test, paired t-Test or Mann-Whitney-U test. Progression Free survival (PFS) and Overall Survival (OS) were estimated using the Kaplan-Meier method.
resultsFifty-one patients with mRCC were included, with a median follow-up of 21 months. 38 (74.5%) patients received IO-based therapies prior to CN, while 13 (25.5%) patients underwent up-front CN. IO-based therapies reduced median tumor size from pretreatment 10 cm to 8.6 cm post-treatment when given prior to CN. IO-TKI had a trend toward higher tumor shrinkage (-2.3 vs -1.2 cm). Pathologic T downstaging occurred in 42% (n=16) of patients, 11% (n=4) of whom had pT0 disease. Thrombus downstaging occurred in 13% (n=6) of patients, all with either partial response (PR) or complete response (CR) in metastases. PFS (HR=0.7, 95% CI 0.29-1.98, p=0.58) and OS (HR 0.4, 95% CI 0.13-1.57, p=0.21) were not statistically significant between 2 cohorts.
conclusionsIO-based therapies, particularly IO-TKIs, resulted in pathologic necrosis and reductions in tumor size prior to deferred CN. PFS and OS were similar for patients who received either upfront IO-based therapy or after CN.
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