Journal of Translational Medicine (Sep 2022)
The prognostic value of the previous nephrectomy in pretreated metastatic renal cell carcinoma receiving immunotherapy: a sub-analysis of the Meet-URO 15 study
- Sara Elena Rebuzzi,
- Alessio Signori,
- Giuseppe Luigi Banna,
- Annalice Gandini,
- Giuseppe Fornarini,
- Alessandra Damassi,
- Marco Maruzzo,
- Ugo De Giorgi,
- Umberto Basso,
- Silvia Chiellino,
- Luca Galli,
- Paolo Andrea Zucali,
- Emanuela Fantinel,
- Emanuele Naglieri,
- Giuseppe Procopio,
- Michele Milella,
- Francesco Boccardo,
- Lucia Fratino,
- Stefania Pipitone,
- Riccardo Ricotta,
- Stefano Panni,
- Veronica Mollica,
- Mariella Sorarù,
- Matteo Santoni,
- Alessio Cortellini,
- Veronica Prati,
- Hector Josè Soto Parra,
- Daniele Santini,
- Francesco Atzori,
- Marilena Di Napoli,
- Orazio Caffo,
- Marco Messina,
- Franco Morelli,
- Giuseppe Prati,
- Franco Nolè,
- Francesca Vignani,
- Alessia Cavo,
- Giandomenico Roviello,
- Pasquale Rescigno,
- Sebastiano Buti
Affiliations
- Sara Elena Rebuzzi
- Medical Oncology Unit
- Alessio Signori
- Department of Health Sciences, Section of Biostatistics, University of Genova
- Giuseppe Luigi Banna
- Candiolo Cancer Institute, FPO-IRCCS
- Annalice Gandini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino
- Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino
- Alessandra Damassi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino
- Marco Maruzzo
- Oncology 1 Unit, Istituto Oncologico Veneto IOV - IRCCS
- Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
- Umberto Basso
- Oncology 1 Unit, Istituto Oncologico Veneto IOV - IRCCS
- Silvia Chiellino
- Medical Oncology Unit, IRCCS Policlinico San Matteo
- Luca Galli
- Medical Oncology Unit 2, Azienda Ospedaliera Universitaria Pisana
- Paolo Andrea Zucali
- Department of Biomedical Sciences, Humanitas University
- Emanuela Fantinel
- Medical Oncology Unit, AUSL-IRCCS of Reggio Emilia
- Emanuele Naglieri
- Division of Medical Oncology, IRCCS Istituto Tumori “Giovanni Paolo II”
- Giuseppe Procopio
- SS Oncologia Medica Genitourinaria, Fondazione IRCCS Istituto Nazionale dei Tumori
- Michele Milella
- Department of Oncology, Azienda Ospedaliera Universitaria Integrata di Verona, University of Verona
- Francesco Boccardo
- Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova
- Lucia Fratino
- Department of Medical Oncology, Centro di Riferimento, Oncologico di Aviano CRO-IRCCS
- Stefania Pipitone
- Medical Oncology Unit, Department of Oncology and Hemathology, University Hospital of Modena
- Riccardo Ricotta
- Oncology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica
- Stefano Panni
- SS Oncologia Medica Genitourinaria, Fondazione IRCCS Istituto Nazionale dei Tumori
- Veronica Mollica
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Mariella Sorarù
- U.O. Oncologia, Ospedale di Camposampiero
- Matteo Santoni
- Oncology Unit, Macerata Hospital
- Alessio Cortellini
- Medical Oncology Department, Campus Bio-Medico University of Rome
- Veronica Prati
- Department of Medical Oncology, Ospedale Michele e Pietro Ferrero
- Hector Josè Soto Parra
- Department of Oncology, Medical Oncology, University Hospital Policlinico-San Marco
- Daniele Santini
- UOC Oncologia Medica, “Sapienza University”, Polo Pontino
- Francesco Atzori
- Medical Oncology Department, University Hospital, University of Cagliari
- Marilena Di Napoli
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale
- Orazio Caffo
- Medical Oncology Department, Santa Chiara Hospital
- Marco Messina
- UOC Oncologia Medica, Istituto Fondazione G. Giglio
- Franco Morelli
- Oncology Department, Gemelli Molise
- Giuseppe Prati
- Department of Oncology and advanced technologies, AUSL - IRCCS Reggio Emilia
- Franco Nolè
- Medical Oncology Division of Urogenital & Head & Neck Tumors, IEO, European Institute of Oncology IRCCS
- Francesca Vignani
- Division of Medical Oncology, Ordine Mauriziano Hospital
- Alessia Cavo
- Oncology Unit, Villa Scassi Hospital
- Giandomenico Roviello
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Firenze
- Pasquale Rescigno
- Candiolo Cancer Institute, FPO-IRCCS
- Sebastiano Buti
- Medical Oncology Unit, University Hospital of Parma
- DOI
- https://doi.org/10.1186/s12967-022-03601-6
- Journal volume & issue
-
Vol. 20,
no. 1
pp. 1 – 7
Abstract
Abstract 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.
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