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Extending Survival in Kidney Cancer: The Promise of Immunotherapy to Prevent Recurrences

by MedOncMD on April 22, 2024

New article published in NEJM demonstrated activity of Pembrolizumab adjuvantly given for resected intermediate, poor risk and resected metastatic RCC.

Kidney cancer remains a significant health challenge worldwide, with renal-cell carcinoma (RCC) being the most common type. Traditionally, surgery has been the primary treatment for localized kidney cancer, but the risk of recurrence remains high. This has led to a continuous search for effective treatments to prevent cancer recurrence and extend survival. Recently, pembrolizumab, a drug used in immunotherapy, has shown promising results as an adjuvant therapy, offering new hope to patients at high risk of recurrence.

Understanding Renal-Cell Carcinoma and Its Treatment:
Renal-cell carcinoma accounts for approximately 90% of all kidney cancers. It is notorious for its resistance to traditional chemotherapy, making post-surgical management critical. While surgery can be effective in removing localized tumors, the risk of RCC returning is significant, especially in advanced cases. This highlights the need for effective adjuvant treatments to improve long-term outcomes.

Breakthrough in Treatment: Adjuvant Pembrolizumab:
The KEYNOTE-564 trial, a pivotal study recently published in the New England Journal of Medicine, investigates the effectiveness of pembrolizumab in improving disease-free and overall survival among RCC patients post-surgery. The trial involved patients with RCC who were at high risk of recurrence; these patients received either pembrolizumab or a placebo after surgery.

How Pembrolizumab Works:
Pembrolizumab targets the programmed cell death protein 1 (PD-1) pathway, a mechanism that tumors use to shield themselves from the immune system. By blocking this pathway, pembrolizumab helps restore the body’s immune response against cancer cells, making it a powerful tool in fighting RCC.

Benefits of Pembrolizumab Therapy:
Results from the KEYNOTE-564 trial were significant. Patients treated with pembrolizumab showed a marked improvement in both disease-free survival (DFS) and overall survival (OS) compared to those who received a placebo. This indicates not only a lower risk of cancer recurrence but also a potential increase in life expectancy.

Considering the Side Effects:
While pembrolizumab marks a significant advancement, it is not without side effects. The trial reported that some patients experienced serious adverse effects, which were manageable with appropriate medical intervention. Patients considering this treatment should discuss potential side effects with their healthcare provider to fully understand the implications.

Patient Perspective:
Patient-reported outcomes from the trial also suggest an improvement in quality of life among those receiving pembrolizumab. This is encouraging as maintaining quality of life is a critical consideration in cancer treatment.

The findings from the KEYNOTE-564 trial represent a breakthrough in the management of renal-cell carcinoma post-surgery. Pembrolizumab not only offers a chance to extend survival but also improves the quality of life for patients at high risk of recurrence.

If you or someone you know is recovering from kidney cancer surgery, a conversation with your healthcare provider about pembrolizumab could be vital. Understanding how this new treatment can be integrated into your care plan is essential for making informed decisions about your health and future.

Dr. Sajeve Thomas is a distinguished medical professional and a compassionate guide in the field of oncology. With over a decade of dedicated experience as a board-certified medical oncologist/internal medicine specialist, Dr. Thomas has become a trusted expert in the treatment of melanoma, sarcoma, and gastrointestinal conditions. Currently practicing at the renowned Orlando Health Cancer Institute, he brings a wealth of expertise to the complex and challenging world of oncology.

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Meet the authors

Dr. Sajeve Thomas
Dr Daniel Landau


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