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Pattern of disease recurrence and outcomes after progression of high-risk renal cell carcinoma (RCC) patients treated with adjuvant immunotherapy - PubMed

4 hours ago
  • #Renal cell carcinoma
  • #Oligometastatic recurrence
  • #Adjuvant immunotherapy
  • Adjuvant pembrolizumab is standard care for high-risk localized RCC post-surgery, yet ~40% relapse within 5 years.
  • Study analyzed 70 high-risk RCC patients (2018–2025): 71% received pembrolizumab, 16% nivolumab+ipilimumab, 13% nivolumab monotherapy.
  • 21% (15 patients) experienced recurrence; 10% relapsed during adjuvant therapy. Oligometastatic disease (67% of recurrences) commonly affected lungs (60%), lymph nodes (33%), and renal bed (13%).
  • At recurrence, 60% started systemic therapy, 33% received loco-regional treatments. 30-month DFS and OS rates were 74% and 94%, respectively.
  • Post-progression survival (OS2) at 24 months was 100% with local therapy alone vs. 86% with systemic therapy.
  • Findings support multidisciplinary, metastasis-directed approaches for recurrent RCC after adjuvant immunotherapy.