Pd18-10 How Is the Efficacy of Patient Selection Criteria for Adjuvant Pembrolizumab After Curative Surgical Treatment of Clear Cell Renal Cell Carcinoma With Intermediate to High Risk of Recurrence? A Real-Life Data Analysis From Single Institutional Experience

You have accessJournal of UrologyKidney Cancer: Advanced (Including Drug Therapy) II (PD18)1 May 2024PD18-10 HOW IS THE EFFICACY OF PATIENT SELECTION CRITERIA FOR ADJUVANT PEMBROLIZUMAB AFTER CURATIVE SURGICAL TREATMENT OF CLEAR CELL RENAL CELL CARCINOMA WITH INTERMEDIATE TO HIGH RISK OF RECURRENCE? A REAL-LIFE DATA ANALYSIS FROM SINGLE INSTITUTIONAL EXPERIENCE Selcuk Erdem, Anil Tantekin, Firat Ozervarli, Rifat Ergul, Yasar Pazir, Ozge Hurdogan, Yasemin Ozluk, Oner Sanli, and Faruk Ozcan Selcuk ErdemSelcuk Erdem , Anil TantekinAnil Tantekin , Firat OzervarliFirat Ozervarli , Rifat ErgulRifat Ergul , Yasar PazirYasar Pazir , Ozge HurdoganOzge Hurdogan , Yasemin OzlukYasemin Ozluk , Oner SanliOner Sanli , and Faruk OzcanFaruk Ozcan View All Author Informationhttps://doi.org/10.1097/01.JU.0001008596.32809.c5.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Adjuvant pembrolizumab is recommended for reducing recurrence risk after curative surgical treatment of intermediate to high risk non-metastatic clear cell renal cell carcinoma (ccRCC). This study investigated the natural course of non-metastatic ccRCC after curative surgery in patients classified by the KEYNOTE-564 patient selection criteria. METHODS: A total of 531 curative and cytoreductive nephrectomies were performed between January 2015 and March 2023 in a tertiary single institution. After exclusion of 235 patients (n=201 non-ccRCC, n=20 incomplete follow-up, n=14 cytoreductive nephrectomy for metastatic renal tumor), a total of 296 non-metastatic ccRCC patients undergoing curative surgery were included into this study. The clinical, histopathological and survival parameters were retrospectively documented from prospectively collected real life database. Chi-square and Mann-Whitney U tests were used for the comparisons of parameters. Kaplan-Meier Analysis was used for survival outcomes. RESULTS: Overall, 76 (25.7%) patients were defined as eligible for adjuvant pembrolizumab (n=66, 86.8%; intermediate to high risk, n=10, 13.2%; high risk). The eligible patients had significantly larger median tumor size in clinical (7.5 vs. 3.9 cm, p<0.001) and pathological (7.8 vs. 3.65 cm, p<0.001) assessments, and underwent more often radical nephrectomy (95.9 vs 27.7%, p<0.001). Two-year recurrence free survival (RFS) was significantly lower (58.6 vs. 94.6%, p<0.001) in eligible patients. A total of 44 (14.9%) patients recurred in overall cohort at median follow-up of 18 months, 25 (32.9%) in eligible group and 19 (8.6%) in non-eligible group. Median pathologic tumor size were larger (9 vs 5 cm, p<0.001) and median time to recurrence were earlier (8 vs. 32 months, p<0.001) in eligible group. Fifty-one (67.1%) patients in eligible group did not experience any recurrence at a median follow-up of 18 months (IQRs:6-30 months). CONCLUSIONS: This real-life data showed that ccRCC recurred after curative surgery in 32.9% of patients defined eligible for adjuvant pembrolizumab, and in 8.5% of patients defined non-eligible. The remaining 67.1% of eligible patients did not recur at median follow-up of 18 months. These results suggested that patient selection criteria defined in KEYNOTE-564 needs to be improved to optimize cost-effectivity in the route of individualized treatment strategies. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e436 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Selcuk Erdem More articles by this author Anil Tantekin More articles by this author Firat Ozervarli More articles by this author Rifat Ergul More articles by this author Yasar Pazir More articles by this author Ozge Hurdogan More articles by this author Yasemin Ozluk More articles by this author Oner Sanli More articles by this author Faruk Ozcan More articles by this author Expand All Advertisement PDF downloadLoading ...