О.A. Voylenko

The influence of neoadjuvant targeted therapy on the choice of surgical treatment of patients with localized renal cell carcinoma

Objective. To increase efficacy of localized RCC treatment by developing a combined approach using neoadjuvant targeted therapy (TT).

Маterials and methods. Results of a randomized clinical study evaluating efficacy of neoadjuvant TT in patients with localized RCC. Main group consisted of 58 randomized patients who underwent 2 cycles of neoadjuvant TT, followed by an assessment of its efficacy and surgical treatment (renal resection or nephrectomy); control group included 60 randomized patients who received only surgical treatment.

Results. Average tumor regression after TT was (M±SD (95% CI)) 20,5±14,3 (16.8-24,3)%. The size of RCC decreased in average by 12,3 mm, from (M±SD (95% CI)) 60,8±19,7 (55,7-66) to 48,5±16,4 (44,2±52, 8) mm (t-test; p<0,001). Tumor size reduction in the group of neoadjuvant TT allowed performing partial nephrectomy in 53 cases (91,4%), whereas in the control group, the number of nephron-sparing surgeries was only 20 (33,3%) (x2=42.1; p<0,0001).

Neoadjuvant TT in patients with localized RCC leads to reliable regression of the tumor, which ensures the possibility of conducting organ-sparing surgical treatment in 91.4% of cases (x2=42.1; p<0.0001).