Surgery enhances immunotherapy in advanced kidney cancer
MD Anderson News Release March 03, 2025
Patients with advanced solid tumors are usually ineligible for surgery. However, surgically removing the primary tumor in preclinical models of metastatic disease helped to overcome immunosuppression, suggesting that surgical resection may enhance antitumor response in patients receiving immune checkpoint therapy. In a prospective pilot trial from the James P. Allison Institute™, researchers led by Padmanee Sharma, M.D., Ph.D., Sangeeta Goswami, M.D., Ph.D., Jianjun Gao, M.D., Ph.D., and Sreyashi Basu, Ph.D., evaluated the safety and efficacy of combining immune checkpoint therapy with cytoreductive surgery or biopsy in 104 patients with clear cell renal cell carcinoma. The median overall survival was 54.7 months for patients receiving immunotherapy plus surgery. Additionally, surgery increased the amount of antigens that could be recognized by T cells and reduced immunosuppressive myeloid cells. These findings suggest that combining surgery with immune checkpoint therapy in a metastatic setting potentially enhances the antitumor response. Learn more in Nature Communications.
The era of immune checkpoint therapy has reshaped treatment for cancer patients and our pilot study provides data supporting the hypothesis that adding debulking surgery to checkpoint inhibitors can improve clinical outcomes for patients with stage 4 renal cell carcinoma. Our analyses will need to be confirmed in additional studies designed to statistically test the hypothesis in a randomized trial.