ArticleInternational journal of clinical oncology2026
Impact of prior primary tumor resection on long-term prognosis in patients with metastatic renal cell carcinoma treated with nivolumab plus ipilimumab: a multicenter analysis.
Article in International journal of clinical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNivolumab plus ipilimumab (NIVO + IPI) is a standard first-line therapy for intermediate-risk and poor-risk metastatic renal cell carcinoma (mRCC), but the long-term prognostic impact of prior primary tumor resection in this setting remains unclear.
methodsWe retrospectively reviewed patients with mRCC that received NIVO + IPI as first-line therapy at eight Japanese institutions between October 2015 and May 2022. Patients were stratified into groups according to timing of metastasis and prior primary tumor resection (cytoreductive nephrectomy; CN): a metachronous group, a synchronous/CN(+) group, and a synchronous/CN(-) group. Progression-free survival, overall survival, and tumor responses were compared among groups, with a median follow-up of 54 months.
resultsAmong 135 eligible patients, 40 were classified into the metachronous group (30%), 37 into the synchronous/CN(+) group (27%), and 58 into the synchronous/CN(-) group (43%). Compared with the synchronous/CN(-) group, both the metachronous and synchronous/CN(+) groups exhibited significantly longer progression-free survival (median: 18 and 19 vs. 6 months, respectively; P < 0.01) and overall survival (median: not reached and 52 vs. 22 months, respectively; P < 0.01). In multivariable analysis, absence of prior primary site resection was independently associated with shorter progression-free survival (P = 0.02) and overall survival (P < 0.01). Objective response and disease control rates were highest in the metachronous group and lowest in the synchronous/CN(-) group.
conclusionIn this multicenter cohort with long-term follow-up, prior primary tumor resection was associated with favorable long-term outcomes in patients with mRCC treated with NIVO + IPI, irrespective of synchronous or metachronous metastasis.
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