A meta-analysis suggests that, overall, adjuvant treatment with immune checkpoint inhibitors (ICIs) does not improve disease-free survival (DFS) in patients with resected renal cell carcinoma (RCC).

However, patients with PD-L1-positive tumors, intermediate- to high-risk disease, or sarcomatoid component derived a benefit from adjuvant ICI treatment. These results were published in Clinical Genitourinary Cancer.

The meta-analysis included 4 studies of 3407 patients receiving adjuvant ICI treatment for localized and/or metastatic resected RCC. There were 496 patients who received pembrolizumab, 390 who received atezolizumab, 404 who received nivolumab, and 405 who received ipilimumab plus nivolumab.

Overall, there was no significant difference in DFS between patients who received adjuvant ICI treatment and those who received placebo (hazard ratio [HR], 0.85; 95% CI, 0.69-1.04).

However, ICI treatment was associated with a DFS benefit for patients with PD-L1-positive tumors (HR, 0.72; 95% CI, 0.55-0.94), those with intermediate- to high-risk disease (HR, 0.77; 95% CI, 0.63-0.94), and those with sarcomatoid component (HR, 0.66; 95% CI, 0.43-0.99).

“This study-level meta-analysis was unable to demonstrate [a] benefit of adjuvant ICI treatment in [the] overall population of localized RCC,” the researchers concluded. “Despite this, in daily clinical practice, the use of adjuvant ICI should be individualized, considering the disease recurrence risk score, comorbidities, patient perspectives, and risk of long-term toxicities.”

Disclosures: Some study authors declared affiliations with the biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Monteiro FSM, Soares A, Rizzo A, et al. The role of immune checkpoint inhibitors (ICI) as adjuvant treatment in renal cell carcinoma (RCC): A systematic review and meta-analysis. Clin Genitourin Cancer. Published online January 19, 2023. doi:10.1016/j.clgc.2023.01.005

Topics:

Genitourinary Cancer Kidney Cancer Renal Cell Carcinoma