What are the goals for neoadjuvant chemotherapy (NAC) in renal cell carcinoma (RCC)? Prof. Jens Bedke (DE) provided important updates on the topic in his presentation, “Neo-adjuvant treatment strategies: Where are we in 2025?” during Plenary Session 10 “Kidney cancer – Advanced and metastatic” led by urologist Prof. Axel Bex (GB), radiotherapist Prof. Ciro Franzese (IT), nuclear medicine physician Prof. Jolanta Kunikowska (PL), radiologist Prof. Harriet Thoeny (CH), and medical oncologist Prof. Yüksel Ürün (TR).
Prof. Bedke stated, “Overall survival (OS) and disease-free survival (DFS) can be prolonged with this neoadjuvant approach. Furthermore, in terms of drugs, immunotherapy combinations seem to be very favourable. However, we can only use what is approved or what is available in the metastatic setting, where we have data on efficacy. The NESCIO trial which demonstrated the efficacy of nivolumab + ipilimumab combination.”
According to Prof. Bedke when discussing surrogate markers, “Imaging such as a conventional CT scan is poor with no good correlation.” In terms of pathology, its importance in the definition of pathological complete response (pCR) or nearly pCR of less than 10% viable tumour cells; and to assess and correlate them. In addition, he pointed out that a biomarker of molecular disease is missing.
During his presentation, he also discussed trials such as aforementioned NESCIO, NIAGARA, IMvigor011, and KEYNOTE-905.
(Re)watch his presentation on the EMUC25 Resource Centre.
