Dr. Voss then discussed specific considerations for targeted immunotherapy with checkpoint inhibitors (CPI) in the neoadjuvant approach. There has been a xenograft model showing data supportive of neoadjuvant over adjuvant PD1 directed therapy. There is also a pilot study performed at MSKCC, assessing neoadjuvant Nivolumab for high risk non-metastatic RCC. Several questions arise for this setting. This includes how close to nephrectomy can the last dose be given? how long do we need to treat pre-operatively for meaningful effect? How much can nephrectomy safely be delayed? should CPI therapy be continued after nephrectomy? And lastly should we target specific patient populations? These questions will be answered in the upcoming clinical trials.
Presented by: Martin Voss, MD Medical Oncologist, Memorial Sloan Kettering Cancer Center , NY, NY
Written by: Hanan Goldberg, MD @GoldbergHanan Society of Urologic Oncology Fellow University of Toronto, Princess Margaret Cancer Centre at the 18th Annual Meeting of the Society of Urologic Oncology, November 20-December 1, 2017 – Washington, DC