Investigating the Addition of Surgery to ICI Therapy in Kidney Cancer

A cytoreductive nephrectomy is a surgery which is performed to remove a kidney tumor that has metastasized (spread) to other areas, according to the Kidney Cancer Association website, which added that this approach has offered the best option to prolong survival for people with metastatic renal cell carcinoma, a type of kidney cancer.

In the phase 3 randomized SWOG S1931 (PROBE) study, investigators evaluated an immune checkpoint inhibitor combination regimen with or without cytoreductive nephrectomy in patients with advanced renal cancer. Overall, investigators aimed to understand if there was a survival benefit to utilizing a cytoreductive nephrectomy in metastatic kidney cancer treatment.

In the trial, patients were initially started on a combination therapeutic regimen and after approximately three months of treatment, patients who presented with either stable disease or partial response were randomized to surgery verses no surgery. All of these patients were then followed for overall survival data analysis.

In order to further discuss the trial, its findings and impact on patients with advanced renal cancer, study author, Dr. Hyung L. Kim sat down to discuss how the addition of cytoreductive nephrectomy to immune checkpoint inhibitor therapy may affect overall survival and quality of life for this patient population.

Kim currently holds various positions at Cedars-Sinai, Urology, located in Los Angeles, including professor; associate director, Urology Residency Training Program; chair, Department of Urology; co-medical director, Urologic Oncology Center; and director, Academic Urology Program. He also serves as the associate director of Surgical Research, as well as the Homer and Gloria Harvey Family Chair in Urologic Oncology in honor of Stuart Friedman, MD.

Transcript:

Most patients have heard of cytoreductive nephrectomy when they begin to do research on their own. [Individuals] with metastatic kidney cancer, when they come to [their] urologist, [understandably] just want their tumor out. We [then] spend a lot of time trying to explain to them that in in the setting of metastatic disease, we don't usually perform surgery.

However, you know, our job is then to explain why we have this trial, why [patients] ought to participate, and how [this will] help us in answering an important question.

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