Can cytoreductive nephrectomy improve outcomes of nivolumab treatment in patients with metastatic clear-cell renal carcinoma?

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dc.contributor.authorOcak, Birol
dc.contributor.authorŞahin, Ahmet Bilgehan
dc.contributor.authorErtürk, İsmail
dc.contributor.authorKorkmaz, Mustafa
dc.contributor.authorÖlmez, Ömer Fatih
dc.contributor.authorGöktaş Aydın, Sabin
dc.contributor.authorEvrensel, Türkkan
dc.date.accessioned2025-07-01T16:10:37Z
dc.date.available2025-07-01T16:10:37Z
dc.date.issued2024
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.description.abstractBackground: This study aimed to investigate the effect of cytoreductive nephrectomy (CN) on the survival outcomes of nivolumab used as a subsequent therapy after the failure of at least one anti-vascular endothelial growth factor (VEGF) agent in patients with metastatic clear-cell renal-cell carcinoma (ccRCC). Methods: We included 106 de novo metastatic ccRCC patients who received nivolumab after progression on at least one anti-VEGF agent. Multivariate Cox regression analysis was performed to investigate the factors affecting survival in patients receiving nivolumab. Results: Of the 106 de novo metastatic ccRCC patients, 83 (78.3%) underwent CN. There were no statistical differences between the two groups in terms of age, gender, Eastern Cooperative Oncology Group (ECOG) score, tumor size, International Metastatic RCC Database Consortium (IMDC) risk group, number of previous treatment lines, first-line anti-VEGF therapy, or metastasis sites (p = 0.137, p = 0.608, p = 0.100, p = 0.376, p = 0.185, p = 0.776, p = 0.350, and p = 0.608, respectively). The patients who received nivolumab with CN had a longer time to treatment discontinuation (TTD) [14.5 months, 95% confidence interval (CI): 8.6–20.3] than did those without CN 6.7 months (95% CI: 3.9–9.5) (p = 0.001). The median overall survival (OS) was 22.7 months (95% CI: 16.1–29.4). The patients with CN had a median OS of 22.9 months (95% CI: 16.3–29.4), while those without CN had a median OS of 8.1 months (95% CI: 5.6–10.5) (p = 0.104). In the multivariate analysis, CN [hazard ratio (HR): 0.521; 95% CI: 0.297–0.916; p = 0.024] and the IMDC risk score (p = 0.011) were statistically significant factors affecting TTD; however, the IMDC risk score (p = 0.006) was the only significant factor for overall survival. Conclusions: Our study showed that the TTD of nivolumab was longer in metastatic ccRCC patients who underwent cytoreductive nephrectomy.
dc.identifier.citationOcak, B., Şahin, A. B., Ertürk, İ., Korkmaz, M., Ölmez, Ö. F., Göktaş Aydın, S. ... Evrensel, T. (2024). Can cytoreductive nephrectomy improve outcomes of nivolumab treatment in patients with metastatic clear-cell renal carcinoma?. Current Oncology, 31(9), 5195-5205. http://dx.doi.org/10.3390/curroncol31090384
dc.identifier.doi10.3390/curroncol31090384
dc.identifier.endpage5205
dc.identifier.issn1198-0052
dc.identifier.issn1718-7729
dc.identifier.issue9
dc.identifier.pmid39330012
dc.identifier.scopus2-s2.0-85205108734
dc.identifier.scopusqualityQ2
dc.identifier.startpage5195
dc.identifier.urihttp://dx.doi.org/10.3390/curroncol31090384
dc.identifier.urihttps://hdl.handle.net/20.500.12511/12997
dc.identifier.volume31
dc.identifier.wosWOS:001323218000001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorÖlmez, Ömer Fatih
dc.institutionauthorGöktaş Aydın, Sabin
dc.institutionauthorid0000-0001-7934-7039
dc.institutionauthorid0000-0002-0077-6971
dc.language.isoen
dc.relation.ispartofCurrent Oncology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectClear-Cell Renal-Cell Carcinoma
dc.subjectCytoreductive Nephrectomy
dc.subjectNivolumab
dc.subjectSurvival
dc.titleCan cytoreductive nephrectomy improve outcomes of nivolumab treatment in patients with metastatic clear-cell renal carcinoma?
dc.typeArticle

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