Madrid, 3 April 2024. Renal cell carcinoma (RCC) is one of the 15 most common tumours worldwide, affecting more than 9,000 patients a year in Spain1, making up 80% of all kidney cancers2. 5-year survival rates are 95% when diagnosed in its initial stages, whilst this drops to 20% in advanced stages3.
According to Dr. Enrique Grande, Head of the Medical Oncology Service and Manager of the Urological Tumour Unit at MD Anderson Cancer Center Madrid, adjuvant treatment for locally advanced renal cancer is currently one of the main topics for debate in the Oncology field. The view is that it can reduce the risk of recurrence while recent data also demonstrates that better overall survival rates in patients can also result.
"For this reason, the appropriate choice for patient treatment should depend on specific criteria that consider the extent and characteristics of the tumour, as well as the general condition of the patient," says Dr. Grande. The specialist maintains that an immunotherapy drug is currently available that can effectively increase the overall survival of kidney cancer patients at a high risk of relapse subsequent to surgical intervention. This was revealed by the KEYNOTE-564 study, where results showed that Pembrolizumab reduces the risk of relapse or death by 37% compared with a placebo4.
According to the expert, this is the first time that a drug has been proven to influence overall survival within the adjuvant setting. "This is a treatment that is applied after surgery, which seeks to reduce the risk of relapse," he explains.
Immunotherapy treatment that destroys hard-to-predict micrometastases
Micrometastases are small accumulations of cancer cells that stem from the primary tumour and spread to distant parts of the body. Detection of these tumour cells is a challenge for specialists because they can be isolated or small in number. In initial studies, when the tumour is confined to the kidney, the normal treatment is surgery, with the patient undergoing a complete or partial nephrectomy”, affirms Dr. Alberto Orta, medical oncologist at MD Anderson Cancer Center Madrid, who maintains that with this immunotherapy treatment “we can destroy these micrometastases to ensure the patient does not suffer from this disease again”.
In recent years, the use of immunotherapy has revolutionized the treatment of many oncological pathologies including melanoma and lung cancer. Even in renal tumours, it has provided excellent results in metastatic diseases. "Oncologists are increasingly using this type of drug. As we have learnt more about the nature of kidney cancer and its biology, new drugs have emerged, but none have managed to achieve significant differences to overall survival within the adjuvant therapy setting”, claimed Dr. Orta.
In this regard, as the oncologist went on to clarify; we generally measure two parameters to evaluate the effectiveness of a drug; disease-free survival (DFS) and overall survival (OS). “Previously, we saw an impact on progression-free survival, but not on overall survival. In other words, the patients lived longer without the disease, but in the end, their life expectancy was the same. As such this study represents a significant advance because it has demonstrated benefits in terms of overall patient survival”, Dr. Alberto Orta concluded.