Affiliation:
1. Department of Genitourinary Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
Abstract
A number of adjuvant trials have attempted to improve outcomes for patients following nephrectomy for renal cell carcinoma (RCC). This was initially with cytokines and then Vascular Endothelial Growth Factor (VEGF) targeted therapies. More recently, a series of adjuvant immune checkpoint inhibitor (ICI) studies have been published. To date, only the KEYNOTE— 564 study using adjuvant pembrolizumab has positive Disease-Free Survival (DFS) data with an acceptable toxicity profile. There are many negative ICI and anti-VEGF adjuvant trials, which raises uncertainty. Further randomised trials may be required but importantly biomarker studies are needed to identify those individuals who may benefit from adjuvant therapy.
Reference22 articles.
1. Identifying patients for adjuvant therapy after nephrectomy;Capitanio;Lancet,2022
2. Adjuvant Pembrolizumab after Nephrectomy in Renal-Cell Carcinoma;Choueiri;New Engl J Med,2021
3. Pembrolizumab versus placebo as post-nephrectomy adjuvant therapy for clear cell renal cell carcinoma (KEYNOTE-564): 30-month follow-up analysis of a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial;Powles;Lancet Oncol,2022
4. Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up;Escudier;Ann Oncol,2016
5. Evaluating Trials of Adjuvant Therapy: Is There Benefit for People With Resected Renal Cancer?;Tannock;J. Clin. Oncol,2023