Current status of adjuvant immunotherapy and relapse management in renal cell carcinoma: Insights from a European delphi study

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61989592%3A15110%2F25%3A73635355" target="_blank" >RIV/61989592:15110/25:73635355 - isvavai.cz</a>

Výsledek na webu

<a href="https://www.ejcancer.com/article/S0959-8049(25)00351-X/fulltext" target="_blank" >https://www.ejcancer.com/article/S0959-8049(25)00351-X/fulltext</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.ejca.2025.115569" target="_blank" >10.1016/j.ejca.2025.115569</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Current status of adjuvant immunotherapy and relapse management in renal cell carcinoma: Insights from a European delphi study

Popis výsledku v původním jazyce

Introduction: Adjuvant immunotherapy has remarkably advanced the management of localized renal cell carcinoma (RCC) in patients at high risk of post-surgery recurrence. This Delphi study aimed to establish expert consensus on its use and subsequent management of relapse. Methods: Fifteen RCC experts participated in a two-round Delphi process between July and November 2024. The study included 43 core survey items, divided into 67 components for comprehensive evaluation. Results: Consensus, defined as ≥ 75 % agreement, was achieved for 39 of 67 items (58.2 %). Experts agreed on using the Leibovich score for selecting patients for adjuvant pembrolizumab (79 %), initiating therapy within 90 days post-surgery (86 %), and not restricting treatment to programmed death ligand-1 (PD-L1)-positive tumors (100 %). Plasma kidney injury molecule-1 (KIM-1) was considered by the experts as a potential useful recurrence risk biomarker (93 %). Immune checkpoint inhibitor (ICI)-refractory disease was defined as relapse within 6 months post-adjuvant therapy (80 %). Focal therapies for oligometastatic recurrence (80 %), and targeted therapies or clinical trial enrollment for ICI-refractory patients (87 %) were supported. Belzutifan was recommended for fourth-line or later use after ICI therapy and multiple tyrosine kinase inhibitors (93 %). By contrast, no consensus was reached on ICI salvage therapy in specific subgroups, including patients with clear-cell RCC (60 %), without bone/brain metastases (60 %), good performance status (60 %), low tumor burden (47 %), or papillary RCC (36 %). Conclusions: This Delphi study provides insights into the evolving role of adjuvant immunotherapy in localized RCC and relapse management. A multidisciplinary approach and periodic review are essential to optimizing treatment strategies.

Název v anglickém jazyce

Current status of adjuvant immunotherapy and relapse management in renal cell carcinoma: Insights from a European delphi study

Popis výsledku anglicky

Introduction: Adjuvant immunotherapy has remarkably advanced the management of localized renal cell carcinoma (RCC) in patients at high risk of post-surgery recurrence. This Delphi study aimed to establish expert consensus on its use and subsequent management of relapse. Methods: Fifteen RCC experts participated in a two-round Delphi process between July and November 2024. The study included 43 core survey items, divided into 67 components for comprehensive evaluation. Results: Consensus, defined as ≥ 75 % agreement, was achieved for 39 of 67 items (58.2 %). Experts agreed on using the Leibovich score for selecting patients for adjuvant pembrolizumab (79 %), initiating therapy within 90 days post-surgery (86 %), and not restricting treatment to programmed death ligand-1 (PD-L1)-positive tumors (100 %). Plasma kidney injury molecule-1 (KIM-1) was considered by the experts as a potential useful recurrence risk biomarker (93 %). Immune checkpoint inhibitor (ICI)-refractory disease was defined as relapse within 6 months post-adjuvant therapy (80 %). Focal therapies for oligometastatic recurrence (80 %), and targeted therapies or clinical trial enrollment for ICI-refractory patients (87 %) were supported. Belzutifan was recommended for fourth-line or later use after ICI therapy and multiple tyrosine kinase inhibitors (93 %). By contrast, no consensus was reached on ICI salvage therapy in specific subgroups, including patients with clear-cell RCC (60 %), without bone/brain metastases (60 %), good performance status (60 %), low tumor burden (47 %), or papillary RCC (36 %). Conclusions: This Delphi study provides insights into the evolving role of adjuvant immunotherapy in localized RCC and relapse management. A multidisciplinary approach and periodic review are essential to optimizing treatment strategies.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30204 - Oncology

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

EUROPEAN JOURNAL OF CANCER

ISSN

—

e-ISSN

1879-0852

Svazek periodika

225

Číslo periodika v rámci svazku

July

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

8

Strana od-do

115569

Kód UT WoS článku

001511440900001

EID výsledku v databázi Scopus

2-s2.0-105007827388