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Lookup NU author(s): Dr Pasquale RescignoORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2022, The Author(s).Background: Nephrectomy is considered the backbone of managing patients with localized and selected metastatic renal cell carcinoma (mRCC). The prognostic role of nephrectomy has been widely investigated with cytokines and targeted therapy, but it is still unclear in the immunotherapy era. Methods: We investigated the Meet-URO-15 study dataset of 571 pretreated mRCC patients receiving nivolumab as second or further lines about the prognostic role of the previous nephrectomy (received in either the localized or metastatic setting) in the overall population and according to the Meet-URO score groups. Results: Patients who underwent nephrectomy showed a significantly reduced risk of death (HR 0.44, 95% CI 0.32–0.60, p < 0.001) with a longer median overall survival (OS) (35.9 months vs 12.1 months), 1-year OS of 71.6% vs 50.5% and 2-years OS of 56.5% vs 22.0% compared to those who did not. No significant interaction between nephrectomy and the overall five Meet-URO score risk groups was observed (p = 0.17). It was statistically significant when merging group 1 with 2 and 3 and group 4 with 5 (p = 0.038) and associated with a longer OS for the first three prognostic groups (p < 0.001), but not for groups 4 and 5 (p = 0.54). Conclusions: Our study suggests an overall positive impact of the previous nephrectomy on the outcome of pretreated mRCC patients receiving immunotherapy. The clinical relevance of cytoreductive nephrectomy, optimal timing and patient selection deserves further investigation, especially for patients with Meet-URO scores of 1 to 3, who are the once deriving benefit in our analyses. However, that benefit is not evident for IMDC poor-risk patients (including the Meet-URO score groups 4 and 5) and a subgroup of IMDC intermediate-risk patients defined as group 4 by the Meet-URO score.
Author(s): Rebuzzi SE, Signori A, Banna GL, Gandini A, Fornarini G, Damassi A, Maruzzo M, De Giorgi U, Basso U, Chiellino S, Galli L, Zucali PA, Fantinel E, Naglieri E, Procopio G, Milella M, Boccardo F, Fratino L, Pipitone S, Ricotta R, Panni S, Mollica V, Soraru M, Santoni M, Cortellini A, Prati V, Soto Parra HJ, Santini D, Atzori F, Di Napoli M, Caffo O, Messina M, Morelli F, Prati G, Nole F, Vignani F, Cavo A, Roviello G, Rescigno P, Buti S
Publication type: Article
Publication status: Published
Journal: Journal of Translational Medicine
Year: 2022
Volume: 20
Issue: 1
Online publication date: 30/09/2022
Acceptance date: 18/08/2022
Date deposited: 08/11/2024
ISSN (electronic): 1479-5876
Publisher: BioMed Central Ltd
URL: https://doi.org/10.1186/s12967-022-03601-6
DOI: 10.1186/s12967-022-03601-6
Data Access Statement: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
PubMed id: 36180954
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