Prognostic impact of systemic therapy change in metastatic renal cell carcinoma treated with cytoreductive nephrectomy. (29th September 2020)

• Record Type: Journal Article
• Authors: Ishihara, Hiroki; Takagi, Toshio; Kondo, Tsunenori; Fukuda, Hironori; Tachibana, Hidekazu; Yoshida, Kazuhiko; Iizuka, Junpei; Kobayashi, Hirohito; Okumi, Masayoshi; Ishida, Hideki; Tanabe, Kazunari
• Is Part Of: Japanese journal of clinical oncology. Volume 51:Number 2(2021)
• Page Start: 296
• Page End: 304
• Publication Date: 2020-09-29
• Subjects: kidney cancer -- nivolumab -- immunotherapy -- PD-1 -- targeted therapy -- renal cancer -- cytoreduction; Oncology -- Periodicals; Cancer -- Periodicals; 616.994005
• DOI: 10.1093/jjco/hyaa171
• Languages: English
• ISSNs: 0368-2811

Abstract

Abstract: Objective: Limited data are available regarding the effect of systemic therapy change in the post-cytokine era on survival of metastatic renal cell carcinoma (mRCC) patients undergoing cytoreductive nephrectomy (CN). Methods: Overall, 161 patients with synchronously mRCC were retrospectively evaluated. The patients were classified into three groups based on the time of diagnosis: (i) early molecular-targeted therapy (mTT) (2008–2011), (ii) late mTT (2012–8/2016) and (iii) immune checkpoint inhibitor (ICI) eras (9/2016–2018). Overall survival (OS) after the diagnosis was compared among the eras. Results: Of the 161 patients, 52 (32%), 75 (46%), and 34 patients (21%) were classified into the early mTT, late mTT and ICI eras, respectively. OS was significantly longer in the ICI and late mTT eras than that in the early mTT era ( P = 0.0065 and P = 0.0010, respectively) but did not significantly differ between the ICI and late mTT eras ( P = 0.389). In 112 patients undergoing CN and systemic therapy, OS was significantly longer in the ICI and late mTT eras than that in the early mTT era ( P = 0.0432 and P = 0.0498, respectively) but did not significantly differ between the ICI and late mTT eras ( P = 0.320). Multivariate analysis of OS in the 161 synchronous mRCC patients revealed that the era was an independent factor ( P < 0.0001), together with the histopathological type ( P = 0.0130), CN status ( P = 0.0010), International Metastatic Renal Cell Carcinoma Database Consortium risk ( P = 0.0002) and liver metastasis status ( P = 0.0124). Conclusion: This retrospective analysis showed that systemic therapy change in the post-cytokine era improved OS of mRCC patients undergoing CN. Abstract : The effect of systemic therapy change in the post-cytokine era on survival in patients undergoing cytoreductive nephrectomy for metastatic renal cell carcinoma was evaluated. The survival improved with the successive eras of systemic therapy.