Ziad Bakouny, MD, MSc, discusses the role of cytoreductive nephrectomy in metastatic renal cell carcinoma.
Ziad Bakouny, MD, MSc, postdoctoral genitourinary oncology research fellow, Dana-Farber Cancer Institute, discusses the role of cytoreductive nephrectomy in metastatic renal cell carcinoma (mRCC).
Historically, patients treated with cytokines derived benefit from cytoreductive nephrectomy, says Bakouny. However, its utility for patients treated with targeted therapy is more controversial.
The role of cytoreductive nephrectomy for patients treated with immune checkpoint inhibitors is not well established, says Bakouny.
A retrospective analysis of 4,639 patients treated with either targeted therapy or a checkpoint inhibitor showed a significant improvement in overall survival with cytoreductive nephrectomy versus without in both patient cohorts.
Additionally, the study showed that younger patients with low-risk mRCC underwent cytoreductive nephrectomy, explains Bakouny. These patients tended to have adverse histologic features which confers lack of benefit to systemic therapies.