Outcomes of treatment, laboratory results, adverse effects, and tolerability of cancer treatment in patients with metastatic renal cell carcinoma treated with ipilimumab and nivolumab after cytoreductive nephrectomy

Abstract

Introduction. This publication aims to present the results of a retrospective analysis of the treatment outcomes of patients with metastatic renal cell carcinoma (mRCC) treated with ipilimumab and nivolumab (IPI-NIVO) who underwent cytore­ductive nephrectomy (CN), radical nephrectomy (RN) or nephron-sparing surgery (NSS) and in whom surgery was omitted. Material and methods. The retrospective analysis includes the results of 34 patients treated and followed at the In­stitute of Oncology, Poznań University of Medical Sciences, from May 2022 to February 2024. Results. Progression-free survival (PFS) was compared in two groups of patients — those who underwent CN (n = 8) and those who had no prior surgical treatment before IPI-NIVO (n = 12). There was a statistically significant difference in the length of PFS between the two groups compared in favour of patients who underwent CN before starting systemic treatment (p = 0.004). The majority of patients (n = 27) reported adverse events during IPI-NIVO treatment. There was no effect of CN performed before initiation of systemic treatment on the occurrence of adverse events du­ring therapy (p = 0.677). The most common reasons for discontinuation of systemic treatment were the drugs adverse effects (n = 8) and disease progression (n = 7). Conclusions. The results presented in the study suggest the important role of CN in the treatment of mRCC. Appro­priate selection of patients suitable for CN is critical to achieving optimal treatment outcomes. Due to limited literature data, further studies are needed to evaluate the role and validity of performing CN in patients with mRCC treated with IPI-NIVO regimens