mRCC: Cytoreductive Nephrectomy May Improve Survival When Combined With Targeted Therapy

Cytoreductive nephrectomy may confer an overall survival benefit when combined with targeted therapy in patients with metastatic renal cell carcinoma (mRCC), a study published in the Journal of Clinical Oncology has shown.¹

Because the role of cytoreductive nephrectomy in the setting of mRCC has become unclear since the introduction of targeted therapies like sorafenib and sunitinib, researchers evaluated   contemporary utilization of cytoreductive nephrectomy and examined the survival benefit of adding cytoreductive nephrectomy to targeted therapy.

Investigators analyzed data from 15,390 patients with mRCC treated with targeted therapy, and found that 35% of the group underwent cytoreductive nephrectomy. Those who were younger, privately insured, treated at an academic center, and had lower tumor stage and cN0 disease were each more likely to undergo cytoreductive nephrectomy.

Median overall survival of patients who underwent cytoreductive nephrectomy was 17.1 months (95% CI, 16.3-18.0), in contrast with 7.7 months (95% CI, 7.4-7.9) for those who did not undergo cytoreductive nephrectomy (P < .001).

The study demonstrated that combining cytoreductive nephrectomy with targeted therapy was associated with a 55% reduction in the risk of death versus targeted therapy alone (hazard ratio, 0.45; 95% CI, 0.40-0.50; P < .001). Cytoreductive nephrectomy prolonged survival by 0.7 months and 3.6 months in patients who survived at least 6 and 24 months, respectively.                       

Reference

1. Hanna N, Sun M, Meyer CP, Nguyen PL, Pal SK, Chang SL, et al. Survival analyses of metastatic renal cancer patients treated with targeted therapy with or without cytoreductive nephrectomy: A National Cancer Data Base study [published online ahead of print June 20, 2016]. J Clin Oncol. doi: 10.1200/JCO.2016.66.7931.