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Can Combination of Targeted Therapy and Immunotherapy Improve Surgical Outcomes in Renal Cell Carcinoma?

By: Vanessa A. Carter, BS
Posted: Monday, August 9, 2021

The safety and efficacy of neoadjuvant PD-1–activated dendritic cell–cytokine-induced killer cell immunotherapy plus either the targeted therapies axitinib or pazopanib in patients with renal cell carcinoma were evaluated by Pei Dong, MD, PhD, of Sun Yat-sen University Cancer Center, Guangzhou, China, and colleagues. Their results, published in Translational Andrology and Urology, revealed that not only were both treatment combinations well tolerated, but they also significantly reduced the size of retroperitoneal lymph nodes, the primary tumor, and tumor thrombus.

The investigators retrospectively reviewed the data on 16 patients with renal cell carcinoma who received PD-1–activated dendritic cell–cytokine-induced killer cell immunotherapy plus either neoadjuvant axitinib (n = 7) or pazopanib (n = 9); all patients were ineligible for a nephrectomy due to safety and feasibility concerns. Instead, treatment was continued until persistent toxicity after dose reduction occurred.

The median patient age was 54 years, with a majority (81.3%) of patients being men. The median treatment duration was 2.1 months, with a median of five immunotherapy cycles. There was an observed decrease in the median tumor volume of 42.3%, and the reduction in patients given axitinib and pazopanib was 15.50 cm3 and 88.77 cm3, respectively. Partial response and stable disease were reported in 3 and 13 individuals, respectively, with most (61.5%) tumors shrinking by more than 30%.

Treatment-related adverse events affected eight participants treated with pazopanib and four treated with axitinib. The most common side effects were hypertension, hand-foot syndrome, proteinuria, arthralgia, mucosal inflammation, and increased serum aspartate aminotransferase and alanine aminotransferase levels. Notably, only patients on pazopanib experienced grade 3 or 4 adverse events. After neoadjuvant therapy, all patients were candidates for appropriate surgeries, 10 of which accepted either nephrectomy or lymph node dissection.

Disclosure: The study authors reported no conflicts of interest.



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