Efficacy of Neoadjuvant Targeted Therapy in Treatment of Patients with Localised Clear-Cell Renal Cell Carcinoma

Aim. This study aimed to evaluate the efficacy of neoadjuvant targeted therapy (TT) in patients with localised clear-cell renal cell carcinoma (RCC). Materials and Methods. A special randomised trial was planned and conducted by the Research Department of Plastic and Reconstructive Oncology in the N...

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Main Authors: O. A. Voylenko, O. E. Stakhovsky, I. V. Vitruk, O. A. Kononenko, M. V. Pikul, S. L. Semko, E. O. Stakhovsky
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Advances in Urology
Online Access:http://dx.doi.org/10.1155/2021/6674637
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author O. A. Voylenko
O. E. Stakhovsky
I. V. Vitruk
O. A. Kononenko
M. V. Pikul
S. L. Semko
E. O. Stakhovsky
author_facet O. A. Voylenko
O. E. Stakhovsky
I. V. Vitruk
O. A. Kononenko
M. V. Pikul
S. L. Semko
E. O. Stakhovsky
author_sort O. A. Voylenko
collection DOAJ
description Aim. This study aimed to evaluate the efficacy of neoadjuvant targeted therapy (TT) in patients with localised clear-cell renal cell carcinoma (RCC). Materials and Methods. A special randomised trial was planned and conducted by the Research Department of Plastic and Reconstructive Oncology in the National Cancer Institute of Ukraine for testing the clinical efficacy of neoadjuvant TT in the treatment of clear-cell localised RCC, and the primary endpoint was tumour response evaluation after TT. The secondary endpoints included evaluation of dependence between the use of neoadjuvant TT and the probability of partial nephrectomy and the correlation between tumour size, stage, remaining functioning parenchyma volume, and response to systemic therapy. Results. Overall, 118 patients met the inclusion criteria and were randomly assigned to receive combined treatment or surgery alone. The percentage of tumour regression ranged from 0% to 60%, and the median was (95% confidence interval) 20.5 ± 14.3 (16.8–24.3%). Most of the patients had a slightly positive response to TT (3%–29% decrease in tumour size); n = 44 (76.9%) cases. Partial response by the Response Evaluation Criteria in Solid Tumours, version 1.1, was observed in 14 (24.1%) patients and reached a maximum of 60% regression. Tumour reduction in the neoadjuvant TT group allowed kidney preservation in 53 (91.4%) patients. In the control group, the number of organ-sparing procedures was significantly lower (n = 20, 33.3%). The statistical difference was relevant (x2 = 42.1; p<0.001). Conclusion. The positive results of neoadjuvant TT obtained in our study indicate the clinical validity of combined treatment in patients with localised RCC.
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spelling doaj-art-a82941fde03f458b96315a3d754cc79e2025-08-20T03:39:08ZengWileyAdvances in Urology1687-63691687-63772021-01-01202110.1155/2021/66746376674637Efficacy of Neoadjuvant Targeted Therapy in Treatment of Patients with Localised Clear-Cell Renal Cell CarcinomaO. A. Voylenko0O. E. Stakhovsky1I. V. Vitruk2O. A. Kononenko3M. V. Pikul4S. L. Semko5E. O. Stakhovsky6Senior Researcher of Department of Plastic and Reconstructive Oncological Urology, National Cancer Institute, 33/43 Lomonosova Str., Kyiv 03022, UkraineSenior Researcher of Department of Plastic and Reconstructive Oncological Urology, National Cancer Institute, 33/43 Lomonosova Str., Kyiv 03022, UkraineSenior Researcher of Department of Plastic and Reconstructive Oncological Urology, National Cancer Institute, 33/43 Lomonosova Str., Kyiv 03022, UkraineResearcher of Department of Plastic and Reconstructive Oncological Urology, National Cancer Institute, 33/43 Lomonosova Str., Kyiv 03022, UkraineUrologist of Department of Plastic and Reconstructive Oncological Urology, National Cancer Institute, 33/43 Lomonosova Str., Kyiv 03022, UkraineUrologist of Department of Plastic and Reconstructive Oncological Urology, National Cancer Institute, 33/43 Lomonosova Str., Kyiv 03022, UkraineHead of Department of Plastic and Reconstructive Oncological Urology, National Cancer Institute, 33/43 Lomonosova Str., Kyiv 03022, UkraineAim. This study aimed to evaluate the efficacy of neoadjuvant targeted therapy (TT) in patients with localised clear-cell renal cell carcinoma (RCC). Materials and Methods. A special randomised trial was planned and conducted by the Research Department of Plastic and Reconstructive Oncology in the National Cancer Institute of Ukraine for testing the clinical efficacy of neoadjuvant TT in the treatment of clear-cell localised RCC, and the primary endpoint was tumour response evaluation after TT. The secondary endpoints included evaluation of dependence between the use of neoadjuvant TT and the probability of partial nephrectomy and the correlation between tumour size, stage, remaining functioning parenchyma volume, and response to systemic therapy. Results. Overall, 118 patients met the inclusion criteria and were randomly assigned to receive combined treatment or surgery alone. The percentage of tumour regression ranged from 0% to 60%, and the median was (95% confidence interval) 20.5 ± 14.3 (16.8–24.3%). Most of the patients had a slightly positive response to TT (3%–29% decrease in tumour size); n = 44 (76.9%) cases. Partial response by the Response Evaluation Criteria in Solid Tumours, version 1.1, was observed in 14 (24.1%) patients and reached a maximum of 60% regression. Tumour reduction in the neoadjuvant TT group allowed kidney preservation in 53 (91.4%) patients. In the control group, the number of organ-sparing procedures was significantly lower (n = 20, 33.3%). The statistical difference was relevant (x2 = 42.1; p<0.001). Conclusion. The positive results of neoadjuvant TT obtained in our study indicate the clinical validity of combined treatment in patients with localised RCC.http://dx.doi.org/10.1155/2021/6674637
spellingShingle O. A. Voylenko
O. E. Stakhovsky
I. V. Vitruk
O. A. Kononenko
M. V. Pikul
S. L. Semko
E. O. Stakhovsky
Efficacy of Neoadjuvant Targeted Therapy in Treatment of Patients with Localised Clear-Cell Renal Cell Carcinoma
Advances in Urology
title Efficacy of Neoadjuvant Targeted Therapy in Treatment of Patients with Localised Clear-Cell Renal Cell Carcinoma
title_full Efficacy of Neoadjuvant Targeted Therapy in Treatment of Patients with Localised Clear-Cell Renal Cell Carcinoma
title_fullStr Efficacy of Neoadjuvant Targeted Therapy in Treatment of Patients with Localised Clear-Cell Renal Cell Carcinoma
title_full_unstemmed Efficacy of Neoadjuvant Targeted Therapy in Treatment of Patients with Localised Clear-Cell Renal Cell Carcinoma
title_short Efficacy of Neoadjuvant Targeted Therapy in Treatment of Patients with Localised Clear-Cell Renal Cell Carcinoma
title_sort efficacy of neoadjuvant targeted therapy in treatment of patients with localised clear cell renal cell carcinoma
url http://dx.doi.org/10.1155/2021/6674637
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