You have accessJournal of UrologyKidney Cancer: Advanced (including Drug Therapy) II (PD40)1 Sep 2021PD40-06 METASTATIC TUMOR DIAMETER RESPONSE IN PATIENTS WITH CLEAR CELL RENAL CELL CARCINOMA IS ASSOCIATED WITH OVERALL SURVIVAL Alberto Pieretti, Daniel Shapiro, Mary E Westerman, Hyunsoo Hwang, Xuemei Wang, Luis A Segarra, Matthew T Campbell, Nizar Tannir, Eric Jonasch, Christopher G Wood, and Jose Karam Alberto PierettiAlberto Pieretti More articles by this author , Daniel ShapiroDaniel Shapiro More articles by this author , Mary E WestermanMary E Westerman More articles by this author , Hyunsoo HwangHyunsoo Hwang More articles by this author , Xuemei WangXuemei Wang More articles by this author , Luis A SegarraLuis A Segarra More articles by this author , Matthew T CampbellMatthew T Campbell More articles by this author , Nizar TannirNizar Tannir More articles by this author , Eric JonaschEric Jonasch More articles by this author , Christopher G WoodChristopher G Wood More articles by this author , and Jose KaramJose Karam More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002050.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Tumor shrinkage of ≥10% with presurgical targeted molecular therapy (TMT) in renal cell carcinoma (RCC) was associated with improved overall survival (OS). We characterized primary and metastatic tumor diameter response and OS in patients with metastatic clear cell RCC (ccRCC) who received preoperative therapy with TMT, immunotherapy (IO), or IO+TMT followed by deferred cytoreductive nephrectomy (dCN). METHODS: We identified 211 patients with metastatic ccRCC who received preoperative therapy followed by dCN between 2005 and 2019. Primary and metastatic tumor longest diameters were calculated from cross-sectional images obtained before systemic therapy and before dCN with validated RECIST 1.1. Kaplan-Meier method was used to estimate OS, and Cox proportional hazards models to assess the association between patient characteristics and OS. RESULTS: A total of 41.4 % of patients had primary tumor shrinkage (PTS) of ≥10%, and 64.1% had metastatic tumor shrinkage (MTS) of ≥10%. Median OS, PTS of ≥10%, and MTS of ≥10% were similar among the 3 groups (p=0.53; p=0.18; p=0.44, respectively). For patients with MTS of ≥10%, the median OS was 44 months compared with 19.1 months in the group with MTS of <10% (p<0.001). On univariable analysis, PTS and MTS of ≥10% were associated with better OS (HR 0.67, CI 0.4-0.9, p=0.02; HR 0.57, CI 0.4-0.7, p<0.001). On multivariable analysis, MTS of ≥10% was associated with improved OS (HR 0.61, CI 0.4-0.8, p=0.01). CONCLUSIONS: In patients with metastatic ccRCC, MTS of ≥10% was associated with better OS in patients who underwent dCN, independent of the type of preoperative systemic therapy. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e676-e676 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alberto Pieretti More articles by this author Daniel Shapiro More articles by this author Mary E Westerman More articles by this author Hyunsoo Hwang More articles by this author Xuemei Wang More articles by this author Luis A Segarra More articles by this author Matthew T Campbell More articles by this author Nizar Tannir More articles by this author Eric Jonasch More articles by this author Christopher G Wood More articles by this author Jose Karam More articles by this author Expand All Advertisement Loading ...