Tumori Journal Abstract Book - October 2020 - 139

H - Genitourinary Tumours	

H04
Impact of previous nephrectomy
on clinical outcome of
metastatic renal carcinoma
treated with immune-oncology
(I-O). A real-world study on behalf
of Meet-URO group (MeetUro-7b)
Stellato M.1, Santini D.2, Verzoni E.1, De Giorgi U.3, Casadei C.3,
Zielli T.4, Maruzzo M.5, Damassi A.6, Sbrana A.7, Di Lorenzo G.8,
Anesi C.2, SorarĂ¹ M.9, Naglieri E.10, De Vivo R.11, Vignani F.12,
Grillone F.13, Mucciarini C.14, Roviello G.15, Pignata S.16, Procopio G.1
1
Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; 2Campus BioMedico University of Rome, Roma; 3Istituto Scientifico Romagnolo per lo
Studio e la Cura dei Tumori (IRST) IRCCS, Meldola; 4University Hospital
of Parma, Parma; 5Istituto Oncologico Veneto IOV IRCCS, Padova; 6IRCCS
Ospedale Policlinico San Martino, Genova; 7Azienda Ospedaliera Universitaria
Pisana, Pisa; 8Ospedale di Pagani, Pagani (Salerno); 9Camposampiero General
Hospital, Camposampiero (Padova); 10Istituto Tumori Bari Giovanni Paolo
II - IRCCS, Bari; 11San Bortolo General Hospital, Vicenza; 12AO Ordine
Mauriziano, Torino; 13Azienda Ospedaliero-Universitario "Mater Domini",
Policlinico of Catanzaro, Catanzaro; 14Ospedale Ramazzini, Carpi-AUSL
Modena, Carpi; 15University of Florence, Firenze; 16Istituto Nazionale Tumori
IRCCS Fondazione "G. Pascale", Napoli

Background: Immune-oncology (IO) treatment demonstrated to improve Overall Survival (OS) in metastatic
renal cell carcinoma (mRCC). The prognostic impact of
previous citoreductive nephrectomy (CN) and radical
nephrectomy with curative intent in patients (pts) treated
with IO is not well defined. Patients and methods 229 eligible pts, with a least one radiological assessment of
response according to the RECIST 1:1 criteria, were retrospectively collected from 16 Italian referral centers.
Baseline characteristics, outcome data including progression-free survival (PFS) and OS were collected. KaplanMeier method and log-rank test were performed to compare
PFS and OS between groups.
Results: 153(66.8%) pts received IO as second line,
61(26.6%) as third line and 15(6.6%) pts as further line. 54
pts (23.6%) were good risk, 144(62.9%) were intermediate
and 31(13.5%) were poor risk according to IMDC score.
189(82.5%) pts underwent nephrectomy (of them
72(32.4%) pts had synchronous metastatic disease and
underwent CN), while 40(17.4%) pts did not. Nephrectomy
was performed before IO treatment. ECOG PS, at the
beginning of IO, was 0 for 167 pts (72.9%), the other 62
(27.1%) had ECOG PS 1 or 2. At a median follow up time
of 17.5 months (mo), 13 (5.7%) pts are still in treatment
while 216 (94.3%) experienced progression. 81 (35.3%)
pts were treated after IO progression with mTOR and
VEGFR inhibitors. 63 (27.5%) pts continued IO beyond
progression. G3-G4 iAE were reported in 46 pts (20%).
Median IO-PFS was 4.5 months in pts who did not undergo
nephrectomy and 2.9 mo in pts who did (HR log rank
0.713, 95%CI 0.4788 to 1.063; p=0.0582). Median IO-OS
was 18.4 mo in pts who underwent nephrectomy and 10.3

139
mo in pts who did not (HR log rank 1.915, 95%CI 1.118 to
3.281; p=0.0024). The difference in OS was irrespective of
the IMDC criteria and the line of treatment.
Conclusions: In our real world experience, in mRCC pts
treated with IO, previous nephrectomy was associated
with a better outcome in terms of OS with all the limitations of a retrospective collection.

H05
Adjuvant chemotherapy in Upper
tract urothelial carcinomas
(UTUCs): is the time ripe for
change? A meta-analysis of 16
studies
Ricci A.D.1, Rizzo A.1, Mollica V.1, Maggio I.1, Ardizzoni A.1, Massari F.1
1

Division of Oncology, S-Orsola-Malpighi Hospital, Bologna

Background: Upper tract urothelial carcinomas (UTUCs)
are a rare malignant disease comprising 5-10% of urothelial carcinomas overall. Radical nephroureterectomy
(RNU) represents the treatment mainstay of the early
stages of UTUCs, but the high rate of relapse and death
means that adjuvant treatments are required. We conducted
a meta-analysis aims to evaluate the role of platinumbased adjuvant chemotherapy (AC) for patients with
locally advanced UTUCs (staged as either pT2-T4 N0-N3
M0 or pTany N1-3) after RNU.
Material and methods: The PubMed/MEDLINE,
EMBASE, Cochrane Library databases and meeting
abstracts were searched for relevant studies in English up
to March 2020. Eligible studies reported survival and/or
disease-free survival (DFS) outcomes expressed as hazard
ratio (HR) and 95% confidence intervals (CIs) for patients
treated with platinum-based AC compared to observation
alone. The endpoints were overall survival (OS), cancerspecific survival (CSS) and DFS.
Results: A total of 16 studies were eligible for analysis: 15
retrospective studies and 1 phase 3 randomized control trial
(RCT). Overall, 1740 patients received AC after RNU and
4535 patients underwent RNU alone, with a median followup of 37,5 months (range 17,8-53,9 months). A significant
benefit in DFS was identified in patients receiving platinumbased AC (pooled HR 0.49; 95%CI: 0.36-0.66), while the
benefit in OS (pooled HR 0.80; 95%CI: 0.51-1.26) and CSS
(pooled HR 0.87; 95%CI: 0.65-1.17) was not statistically
significant. Additionally, platinum-based AC showed a
modest OS benefit with a pooled HR 0.75 (95%CI: 0.57-
0.99) in a post-hoc analysis combing multivariable HRs
with estimated HRs from Kaplan-Meier curves.
Conclusions: The available data suggest that platinumbased AC is associated with improved DFS and a modest
OS benefit after RNU in patients with locally advanced
UTUCs.



Tumori Journal Abstract Book - October 2020

Table of Contents for the Digital Edition of Tumori Journal Abstract Book - October 2020

Contents
Tumori Journal Abstract Book - October 2020 - Cover1
Tumori Journal Abstract Book - October 2020 - Cover2
Tumori Journal Abstract Book - October 2020 - I
Tumori Journal Abstract Book - October 2020 - II
Tumori Journal Abstract Book - October 2020 - Contents
Tumori Journal Abstract Book - October 2020 - IV
Tumori Journal Abstract Book - October 2020 - V
Tumori Journal Abstract Book - October 2020 - 1
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Tumori Journal Abstract Book - October 2020 - Cover3
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