MP12-10 POTENTIAL SURVIVAL BENEFIT OF DEFERRED NEPHRECTOMY IN PATIENTS TREATED WITH NIVOLUMAB PLUS IPILIMUMAB FOR METASTATIC RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyCME1 May 2022MP12-10 POTENTIAL SURVIVAL BENEFIT OF DEFERRED NEPHRECTOMY IN PATIENTS TREATED WITH NIVOLUMAB PLUS IPILIMUMAB FOR METASTATIC RENAL CELL CARCINOMA Maki Yoshino, Hiroki Ishihara, Yuki Nemoto, Kazutaka Nakamura, Hidekazu Tachibana, Hironori Fukuda, Kazuhiko Yoshida, Hirohito Kobayashi, Junpei Iizuka, Shimmura Hiroaki, Yasunobu Hashimoto, Toshio Takagi, Tsunenori Kondo, and Kazunari Tanabe Maki YoshinoMaki Yoshino More articles by this author , Hiroki IshiharaHiroki Ishihara More articles by this author , Yuki NemotoYuki Nemoto More articles by this author , Kazutaka NakamuraKazutaka Nakamura More articles by this author , Hidekazu TachibanaHidekazu Tachibana More articles by this author , Hironori FukudaHironori Fukuda More articles by this author , Kazuhiko YoshidaKazuhiko Yoshida More articles by this author , Hirohito KobayashiHirohito Kobayashi More articles by this author , Junpei IizukaJunpei Iizuka More articles by this author , Shimmura HiroakiShimmura Hiroaki More articles by this author , Yasunobu HashimotoYasunobu Hashimoto More articles by this author , Toshio TakagiToshio Takagi More articles by this author , Tsunenori KondoTsunenori Kondo More articles by this author , and Kazunari TanabeKazunari Tanabe More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002534.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: he therapeutic role of cytoreductive nephrectomy has been intensively discussed after the CARMENA and SURTIME trials. We aimed to clarify the survival benefit of deferred nephrectomy after frontline nivolumab plus ipilimumab (Nivo/Ipi) for metastatic renal cell carcinoma (mRCC). METHODS: We retrospectively evaluated 74 patients with mRCC who received Nivo/Ipi at our five affiliated institutions. Patients were divided into three groups depending on the nephrectomy status; patients who received nephrectomy prior to initiation of Nivo/Ipi (pNx), who received deffered Nx (dNx), or who have not received Nx (-Nx). Overall survival was compared among the three groups and perioperative outcomes of the dNx group were evaluated. RESULTS: Of the 74 patients, seven (9%) received dNx, 53 (72%) received pNx, and 14 (19%) have not undergone nephrectomy (-Nx) (Table 1). Deferred Nx was conducted at the median six months after the initiation of Nivo/Ipi. Overall survival was significantly higher in the dNx group than in the pNx and -Nx groups (1-year rate: 100% vs 86% vs 54%, p = 0.01) (Figure 1). Perioperative outcomes were generally not specific, but three patients required blood transfusion (Clavien-dindo Grade II). During the follow-up with median 10 months after dNx, all seven patients were alive; three patients received nivolumab for other targeted lesions, three patients obtained drug free interval, and one patient received subsequent targeted therapy due to apparent disease progression. CONCLUSIONS: Cytoreductive nephrectomy deferred to Nivo/Ipi is a potentially feasible therapeutic option in carefully selected patients. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e170 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Maki Yoshino More articles by this author Hiroki Ishihara More articles by this author Yuki Nemoto More articles by this author Kazutaka Nakamura More articles by this author Hidekazu Tachibana More articles by this author Hironori Fukuda More articles by this author Kazuhiko Yoshida More articles by this author Hirohito Kobayashi More articles by this author Junpei Iizuka More articles by this author Shimmura Hiroaki More articles by this author Yasunobu Hashimoto More articles by this author Toshio Takagi More articles by this author Tsunenori Kondo More articles by this author Kazunari Tanabe More articles by this author Expand All Advertisement PDF DownloadLoading ...