there is an effective cure to reduce the risk of recurrence after surgery –

by time news

Even after surgery, it is not uncommon for renal cell carcinoma to recur. It happens in about a third of patients, and when it does the treatment options for hoping for recovery are limited today, but the results of the KEYNOTE-564 study open up promising new perspectives and indicate that immunotherapy after surgery could soon become the new standard of health. care. Cos Julie R Grallow, vice president of the American Society of Clinical Oncology (Asco), commented on the results of the phase three trial presented during the plenary session of the annual congress running until June 8, which affects the kidneys is a subtle and insidious neoplasm because it often remains clinically silent for most of its course and the most evident symptoms only occur when the disease is already in an advanced stage, more difficult to cure. Now for immunotherapy, administered after excision, it has been shown to significantly reduce the risk of recurrence and death of patients with renal cell carcinoma.

The study of nearly a thousand patients

KEYNOTE-564 a phase three study that enrolled 994 patients with renal cell carcinoma intermediate to high or high risk of relapse after nephrectomy (surgical removal of a kidney) or after nephrectomy, including those undergoing resentment of metastatic lesions and disease free upon re-evaluation. Participants received immunotherapy with pembrolizumab or a placebo and the results show that, about two years later (median follow-up of 24.1 months), with the new therapy there was a statistically significant and clinically relevant reduction in the risk of relapse of 32% illness or death compared to placebo. For the first time, an adjuvant treatment, i.e. after surgery, has proven effective in patients with kidney cancer to prevent recurrence – he explains Sergio Bracarda, director of the Oncology and Medical and Translational Oncology Department of the Santa Maria di Terni Hospital -. In 2020, 13,520 new diagnoses of kidney cancer were estimated in Italy. Overall, recurrence after surgery affects about 30% of total cases and this percentage is even higher if only cases classified as intermediate or high risk are considered. To date, for these patients, after surgery, there are no therapeutic options available other than careful observation with regular checks. There was a lack of studies that could support a concrete benefit in reducing the risk of relapse with drug treatment.

Symptoms not to be overlooked and risk factors

Ematuria, i.e. the presence of blood in the urine, dull flank pain or colic-like spasms, caused by the presence of blood clots along the urinary tract (renal pelvis and ureter), the presence of a palpable mass in the abdominal cavity at the level of the flank are the symptoms that should not be overlooked. If the cancer is diagnosed at an early stage, in fact, about 70% of patients have a good chance of recovery. In the KEYNOTE-564 trial – continues Bracarda -, methodologically well conducted (randomized, prospective, double-blind and with a large sample), pembrolizumab was shown to be effective in reducing the risk of relapse or death by 32% compared to placebo. associated with an acceptable tolerability profile and a favorable overall survival trend in patients operated on for clear cell RCC at intermediate-high or high risk of relapse. Pembrolizumab immunotherapy, which has already achieved important results in advanced disease, opens up a new perspective for its use even at an earlier stage, just after surgery. Kidney cancer mainly affects men, but cases are steadily increasing in both sexes. Bad habits that are increasingly widespread also in Italy are being blamed: overweight, obesity, hypertension, incorrect diet, sedentary lifestyle. And above all, smoking.

June 7, 2021 (change June 7, 2021 | 12:42)


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