Piotr Wysocki: Neoadjuvant therapy for renal-cell cancer patients is still in its infancy, unlike in melanoma
Piotr Wysocki recently posted on LinkedIn:
“The PROSPER ECOG-ACRIN EA8143 study (published online in Lancet Oncology) evaluated the use of nivolumab (1 cycle) before nephrectomy followed by adjuvant nivolumab (9 cycles) in patients with high-risk renal cell carcinoma (RCC). The trial enrolled 819 patients (48% – cT3-4; 15% – N+; 71% – clear-cell carcinoma; 10% – presence of sarcomatoid features) who were randomized to receive either nivolumab plus surgery or surgery only followed by surveillance.
With the median follow-up of 30·4 months, recurrence-free survival (primary endpoint) was not significantly different between nivolumab
- 33% RFS events in nivolumab+surgery and 33% in surgery-only arms – HR for RFS=0.94 [95% CI 0·74–1·21]
Secondary Endpoints:
- 12-month disease-free survival rates – 89% (nivolumab+surgery) and 93% (surgery only)
- 12-month overall survival rates – 93% (nivolumab+surgery) and 93% (surgery only)
Despite its long-known immunogenicity, claimed by many to be similar to skin melanoma, RCC remains a challenging issue in adjuvant and neoadjuvant treatment strategies. Among various immunotherapies active in palliative settings (nivolumab, nivolumab+ipilimumab, pembrolizumab+TKI, nivolumab+TKI) only pembrolizumab improved outcomes in RCC patietns when used as adjuvant therapy.
It seems that we still have a long way to go until we can establish active and safe neoadjuvant therapy in RCC patients.”
Authors: Mohamad E Allaf, Se-Eun Kim, Prof Viraj Master, David F McDermott, Lauren C Harshman, Suzanne M Cole, Prof Charles G Drake, Sabina Signoretti, Mahmut Akgul, Nicholas Baniak, Elsa Li-Ning, Matthew B Palmer, Hamid Emamekhoo, Nabil Adra, Hristos Kaimakliotis, Yasser Ged, Phillip M Pierorazio, E Jason Abel, Mehmet A Bilen, Kenneth Ogan, Helen H Moon, Krishna A Ramaswamy, Eric A Singer, Tina M Mayer, Jay Lohrey, Prof Vitaly Margulis, Jessie Gills, Scott E Delacroix, Mark J Waples, Andrew C James, Peng Wang, Toni Choueiri, M Dror Michaelson, Anil Kapoor, Daniel Y Heng, Brian Shuch, Bradley C Leibovich, Primo N Lara, Judith Manola, Deborah Maskens, Dena Battle, Robert Uzzo, Gennady Bratslavsky, Naomi B Haas and Michael A Carducci.
Source: Piotr Wysocki/LinkedIn
Piotr Wysocki leads the Clinical Oncology Department at University Hospital and the Faculty of Oncology at Jagiellonian University-Medical College in Krakow, Poland. As an advisor to the Polish Ministry of Health, he shapes the national cancer strategy.
His clinical expertise spans the systemic treatment of breast, gynecologic, and genitourinary cancers, with a focus on developing innovative metronomic chemotherapy-based therapies for advanced cancer patients who have undergone prior treatment.
Read other posts by Piotr Wysocki published on OncoDaily.
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