Pathologic response and surgical outcomes in patients undergoing nephrectomy following receipt of immune checkpoint inhibitors for renal cell carcinoma

Complete Pathologic Responses With Immunotherapy in Metastatic Renal Cell Carcinoma: Case Reports

“…Review of published literature revealed five other reported cases of complete pathologic response to immunotherapy in RCC at time of radical nephrectomy: three cases after treatment with nivolumab monotherapy, one after combination nivolumab plus ipilimumab, and one after combination nivolumab plus cabozantinib ( 9 – 14 ). To our knowledge, we present the first reported complete pathologic response after treatment with combination pembrolizumab plus axitinib and add an additional case after treatment with second-line nivolumab monotherapy.…”

Neoadjuvant Nivolumab in Patients with High-risk Nonmetastatic Renal Cell Carcinoma

“…Data on the impact of neoadjuvant immune checkpoint blockade on intra-and postoperative complications are relatively limited at the present time. Additionally, the effect of these agents on the primary tumor in cases of nonmetastatic RCC remains an open question, as current experience with prenephrectomy immune checkpoint blockade has been limited to retrospective studies involving mostly patients with metastatic disease [4][5][6]. Herein, we provide the results of an early phase clinical trial evaluating neoadjuvant administration of the PD-1 inhibitor nivolumab in patients with nonmetastatic high-risk clear cell RCC.…”

Locally Advanced Kidney Cancer: A New Space for Immunotherapy?

“…In this issue of European Urology Oncology, Gorin et al [2] present results from their phase 1 clinical trial assessing the safety of nephrectomy after three cycles of neoadjuvant nivolumab in 17 patients with high-risk RCC. Their work adds prospective support to a growing body of literature, as other retrospective series have likewise shown that nephrectomy following ICI for RCC is safe and feasible [3][4][5]. Compared to the adjuvant setting, neoadjuvant administration of ICI may uniquely enhance the antitumor T-cell response induced by the primary tumor while the tumor remains in situ, as supported by preclinical evidence [6].…”