Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Eur Urol Focus. 2023 Mar;9(2):275-277. doi: 10.1016/j.euf.2023.01.022. Epub 2023 Feb 10.
Immune checkpoint inhibitors (ICIs) have led to substantial changes in systemic treatment for metastatic renal cell carcinoma (mRCC). For patients whose metastases respond to upfront ICI therapy, deferred cytoreductive nephrectomy (CN) may confer a survival advantage. Further data from ongoing trials are awaited regarding the role of deferred versus immediate CN for mRCC in the ICI era. PATIENT SUMMARY: The first-line treatment currently recommended for kidney cancer that has spread to other sites is immunotherapy. For patients who experience a good response to this treatment, surgical kidney removal to control the primary tumor may have a survival benefit. More evidence from clinical trials is needed to confirm the efficacy of this approach.
免疫检查点抑制剂 (ICIs) 已导致转移性肾细胞癌 (mRCC) 的全身治疗发生重大变化。对于转移性病变对初始 ICI 治疗有反应的患者，推迟肾细胞减瘤术 (CN) 可能会带来生存优势。正在进行的试验中有更多关于在 ICI 时代 mRCC 中推迟与立即 CN 的作用的数据有待期待。患者总结：目前推荐的转移性肾癌一线治疗是免疫疗法。对于对这种治疗有良好反应的患者，手术切除肾脏以控制原发病灶可能会带来生存获益。还需要来自临床试验的更多证据来证实这种方法的疗效。
