Research Article

The Benefit of Upfront Cytoreductive Surgery on the Effect of Immunotherapy After Tyrosine Kinase Inhibitor Therapies in Clear Cell Renal Cell Carcinomas

Volume: 12 Number: 1 September 21, 2026
TR EN

The Benefit of Upfront Cytoreductive Surgery on the Effect of Immunotherapy After Tyrosine Kinase Inhibitor Therapies in Clear Cell Renal Cell Carcinomas

Abstract

Aim: This study aimed to evaluate the effect of upfront cytoreductive nephrectomy on survival outcomes in patients with metastatic clear cell renal cell carcinoma (RCC) who received tyrosine kinase inhibitor (TKI) therapy followed by immunotherapy (nivolumab). Materials and Methods: This retrospective, single-center study included 38 patients treated between 2010 and 2023. All patients received sunitinib as first-line and nivolumab as second-line therapy. The patients were divided into two groups based on whether they underwent primary tumor resection (PTR group) or not (non-PTR group). Progression-free survival (PFS1, PFS2) and overall survival (OS) were assessed by Kaplan-Meier analysis. Results: The objective response rate was 79% in the PTR group and 22% in the non-PTR group (p=0.003). The median PFS1 was 16.7 months in the PTR group and 7.1 months in the non-PTR group (p=0.006). Median PFS2 was not reached in the PTR group, whereas it was 54.1 months in the non-PTR group (p=0.290). Although the OS was longer in the PTR group, the difference was not statistically significant (p=0.108). Conclusion: Upfront cytoreductive nephrectomy appears to improve response rates and progression-free survival in patients with metastatic RCC receiving sequential TKI and nivolumab therapy. However, this effect on overall survival was not statistically significant. These findings warrant validation through prospective, large-scale studies.

Keywords

References

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Details

Primary Language

English

Subjects

Clinical Oncology

Journal Section

Research Article

Publication Date

September 21, 2026

Submission Date

January 15, 2026

Acceptance Date

February 12, 2026

Published in Issue

Year 2026 Volume: 12 Number: 1

APA
Avşar Küçükkurt, E., & Kıvrak Salim, D. (2026). The Benefit of Upfront Cytoreductive Surgery on the Effect of Immunotherapy After Tyrosine Kinase Inhibitor Therapies in Clear Cell Renal Cell Carcinomas. Akdeniz Tıp Dergisi, 12(1). https://doi.org/10.53394/akd.1864045
AMA
1.Avşar Küçükkurt E, Kıvrak Salim D. The Benefit of Upfront Cytoreductive Surgery on the Effect of Immunotherapy After Tyrosine Kinase Inhibitor Therapies in Clear Cell Renal Cell Carcinomas. Akd Med J. 2026;12(1). doi:10.53394/akd.1864045
Chicago
Avşar Küçükkurt, Esin, and Derya Kıvrak Salim. 2026. “The Benefit of Upfront Cytoreductive Surgery on the Effect of Immunotherapy After Tyrosine Kinase Inhibitor Therapies in Clear Cell Renal Cell Carcinomas”. Akdeniz Tıp Dergisi 12 (1). https://doi.org/10.53394/akd.1864045.
EndNote
Avşar Küçükkurt E, Kıvrak Salim D (September 1, 2026) The Benefit of Upfront Cytoreductive Surgery on the Effect of Immunotherapy After Tyrosine Kinase Inhibitor Therapies in Clear Cell Renal Cell Carcinomas. Akdeniz Tıp Dergisi 12 1
IEEE
[1]E. Avşar Küçükkurt and D. Kıvrak Salim, “The Benefit of Upfront Cytoreductive Surgery on the Effect of Immunotherapy After Tyrosine Kinase Inhibitor Therapies in Clear Cell Renal Cell Carcinomas”, Akd Med J, vol. 12, no. 1, Sept. 2026, doi: 10.53394/akd.1864045.
ISNAD
Avşar Küçükkurt, Esin - Kıvrak Salim, Derya. “The Benefit of Upfront Cytoreductive Surgery on the Effect of Immunotherapy After Tyrosine Kinase Inhibitor Therapies in Clear Cell Renal Cell Carcinomas”. Akdeniz Tıp Dergisi 12/1 (September 1, 2026). https://doi.org/10.53394/akd.1864045.
JAMA
1.Avşar Küçükkurt E, Kıvrak Salim D. The Benefit of Upfront Cytoreductive Surgery on the Effect of Immunotherapy After Tyrosine Kinase Inhibitor Therapies in Clear Cell Renal Cell Carcinomas. Akd Med J. 2026;12. doi:10.53394/akd.1864045.
MLA
Avşar Küçükkurt, Esin, and Derya Kıvrak Salim. “The Benefit of Upfront Cytoreductive Surgery on the Effect of Immunotherapy After Tyrosine Kinase Inhibitor Therapies in Clear Cell Renal Cell Carcinomas”. Akdeniz Tıp Dergisi, vol. 12, no. 1, Sept. 2026, doi:10.53394/akd.1864045.
Vancouver
1.Esin Avşar Küçükkurt, Derya Kıvrak Salim. The Benefit of Upfront Cytoreductive Surgery on the Effect of Immunotherapy After Tyrosine Kinase Inhibitor Therapies in Clear Cell Renal Cell Carcinomas. Akd Med J. 2026 Sep. 1;12(1). doi:10.53394/akd.1864045