دورية أكاديمية

The prognostic value of the previous nephrectomy in pretreated metastatic renal cell carcinoma receiving immunotherapy: a sub-analysis of the Meet-URO 15 study

التفاصيل البيبلوغرافية
العنوان: The prognostic value of the previous nephrectomy in pretreated metastatic renal cell carcinoma receiving immunotherapy: a sub-analysis of the Meet-URO 15 study
المؤلفون: Rebuzzi, Sara Elena, Signori, Alessio, Banna, Giuseppe Luigi, Gandini, Annalice, Fornarini, Giuseppe, Damassi, Alessandra, Maruzzo, Marco, De Giorgi, Ugo, Basso, Umberto, Chiellino, Silvia, Galli, Luca, Zucali, Paolo Andrea, Fantinel, Emanuela, Naglieri, Emanuele, Procopio, Giuseppe, Milella, Michele, Boccardo, Francesco, Fratino, Lucia, Pipitone, Stefania, Ricotta, Riccardo, Panni, Stefano, Mollica, Veronica, Sorarù, Mariella, Santoni, Matteo, Cortellini, Alessio, Prati, Veronica, Soto Parra, Hector Josè, Santini, Daniele, Atzori, Francesco, Di Napoli, Marilena, Caffo, Orazio, Messina, Marco, Morelli, Franco, Prati, Giuseppe, Nolè, Franco, Vignani, Francesca, Cavo, Alessia, Roviello, Giandomenico, Rescigno, Pasquale, Buti, Sebastiano
المصدر: Journal of Translational Medicine ; volume 20, issue 1 ; ISSN 1479-5876
بيانات النشر: Springer Science and Business Media LLC
سنة النشر: 2022
مصطلحات موضوعية: General Biochemistry, Genetics and Molecular Biology, General Medicine
الوصف: 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.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1186/s12967-022-03601-6
DOI: 10.1186/s12967-022-03601-6.pdf
DOI: 10.1186/s12967-022-03601-6/fulltext.html
الإتاحة: https://doi.org/10.1186/s12967-022-03601-6Test
حقوق: https://creativecommons.org/licenses/by/4.0Test ; https://creativecommons.org/licenses/by/4.0Test
رقم الانضمام: edsbas.9D6B0DE
قاعدة البيانات: BASE