Adjuvant neoadjuvant treatment in RCC J L Gonzlez

Adjuvant & neoadjuvant treatment in RCC J. L González Larriba Hospital Clínico San Carlos Universidad Complutense. Madrid #SEOM 2019

Disclosures • Employment: Ministry of Education, Culture and Sports; SERMAS • Honoraria: MSD, Astra. Zeneca, Roche, Pfizer, Janssen-Cilag, Novartis, Astellas, Bristol-Myers Squibb • Consultant or Advisory Role: MSD Oncology, Janssen-Cilag, Bristol-Myers Squibb, Boehringer Ingelheim • Speakers´Bureau: MSD • Research Funding: Roche, Novartis, Boehringer Ingelheim, Abbvie, Celgene, Pfizer, Mirati Therapeutics, Ignyta, Pharma. Mar, Astra. Zeneca, Onco. Med, Bristol-Myers Squibb, Bayer, Astellas Pharma, Janssen-Cilag • Travel, Acommodations, Expenses: MSD Oncology, Takeda, Bristol-Myers Squibb, Roche, Pfizer, Janssen-Cilag

Adjuvant Trials in RCC in 2019: Essentials

RCC survival outcomes SEER 2005 -2011

Patterns of failure following surgical resection of renal cell carcinoma Rabinovitch RA, et al. J Clin Oncol 1994

Prognostic models Nandagopal L, et al. Curr Treat Options 2018

Prognostic models: UISS score Zisman, et al. J Clin Oncol 2010

Prognostic models: Leibovich score Leibovich et al. Cancer 2013

Adjuvant Trials in RCC : Essentials Effective therapy Feasible therapy Selection of patients

Classic trials in the adjuvant setting Dizman, et al. Clinical Advances in Hematol & Oncol 2018

ARISER trial: Girentuximab in adjuvant treatment Belldegrun et al. ASCO GU 2013

ARISER trial: Girentuximab in adjuvant treatment Chamie K et al. JAMA Oncology 2016

ARISER trial: Girentuximab in adjuvant treatment High CAIX and age<65 y Belldegrun et al. ASCO GU 2013

Adjuvant Trials in RCC in the TKI´s Era: Rational for use Poor prognosis for selected groups after nephrectomy. No proven adjuvant treatment. Efficacy of TKI´s in advanced disease. TKI´s are suitable for prolonged use

New trials with “new drugs” in the adjuvant setting

Adjuvant RCTs in RCC Suarez C. ESMO 2019

Adjuvant RCTs in RCC Suarez C. ESMO 2019

Figlin R, et al. Ann Oncol 2018

DFS OS High grade AE Sum M, et al. Eur Urol 2018 Riaz IB, et al. Mayo Clin Proc 2019

De Almeida DVP, et al. ASCO 2019

Bex A, et al. Eur Urol 2016

Bex A, et al. Eur Urol 2016

On going studies: IO in the adjuvant setting? Mc. Dermott, et al. J Clin Oncol 2016

On going studies: IO in the adjuvant setting? Mc. Dermott, et al. J Clin Oncol 2016

On going studies

Conclusions

What should neoadjuvant targeted therapy for localized RCC achieve?

Neoadjuvant treatment in RCC Bindayi, et al. Urol Oncol 2018

Neoadjuvant treatment in RCC Abel, 2011

Neoadjuvant treatment in RCC

Neoadjuvant/adjuvant

Gracias J. L. González Larriba Hospital Clínico San Carlos Universidad Complutense. Madrid jglarriba@salud. madrid. org #SEOM 2019