Radical Nephrectomy After Immune Checkpoint Inhibitors for Metastatic Renal Cell Carcinoma

Takafumi Yanagisawa; Manuela Schmidinger; Tatsushi Kawada; Kensuke Bekku; Takahiro Kimura; Shahrokh F Shariat

doi:10.1016/j.euf.2023.01.022

Radical Nephrectomy After Immune Checkpoint Inhibitors for Metastatic Renal Cell Carcinoma

Eur Urol Focus. 2023 Mar;9(2):275-277. doi: 10.1016/j.euf.2023.01.022. Epub 2023 Feb 10.

Authors

Takafumi Yanagisawa¹, Manuela Schmidinger², Tatsushi Kawada³, Kensuke Bekku³, Takahiro Kimura⁴, Shahrokh F Shariat⁵

Affiliations

¹ Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
² Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. Electronic address: manuela.schmidinger@meduniwien.ac.at.
³ Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
⁴ Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
⁵ Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Division of Urology, Department of Special Surgery, The University of Jordan, Amman, Jordan; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czechia; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.

PMID: 36775716
DOI: 10.1016/j.euf.2023.01.022

Abstract

Immune checkpoint inhibitors (ICIs) have led to substantial changes in systemic treatment for metastatic renal cell carcinoma (mRCC). For patients whose metastases respond to upfront ICI therapy, deferred cytoreductive nephrectomy (CN) may confer a survival advantage. Further data from ongoing trials are awaited regarding the role of deferred versus immediate CN for mRCC in the ICI era. PATIENT SUMMARY: The first-line treatment currently recommended for kidney cancer that has spread to other sites is immunotherapy. For patients who experience a good response to this treatment, surgical kidney removal to control the primary tumor may have a survival benefit. More evidence from clinical trials is needed to confirm the efficacy of this approach.

Keywords: Cytoreductive nephrectomy; Immune checkpoint inhibitors; Metastatic renal cell carcinoma.

Publication types

Review

MeSH terms

Carcinoma, Renal Cell* / drug therapy
Carcinoma, Renal Cell* / surgery
Cytoreduction Surgical Procedures
Humans
Immune Checkpoint Inhibitors / therapeutic use
Kidney Neoplasms* / drug therapy
Kidney Neoplasms* / pathology
Kidney Neoplasms* / surgery
Nephrectomy

Substances

Immune Checkpoint Inhibitors