ĐIỀU TRỊ BỔ TRỢ UNG THƯ TẾ BÀO THẬN SAU PHẪU THUẬT TRONG KỶ NGUYÊN LIỆU PHÁP MIỄN DỊCH: KINH NGHIỆM BƯỚC ĐẦU TẠI BỆNH VIỆN CHỢ RẪY

Abstract

Objective: Radical nephrectomy has been the standard treatment for high-risk or locally advanced renal cell carcinoma (RCC), which carries a significant risk of progression and poor outcomes, especially given the limited effectiveness of traditional adjuvant therapies. Recently, immune checkpoint inhibitors have emerged as a major advancement in the comprehensive management of RCC. This study reports cases treated with adjuvant immunotherapy following nephrectomy for RCC at our center.

Methods: This is a case series study. Patients with RCC who underwent radical nephrectomy, with histopathology confirming clear cell carcinoma and classified as intermediate- to high-risk or higher according to KEYNOTE-564 criteria, and who were deemed to have achieved complete tumor resection evaluated by chest-abdomen-pelvis CT scans, received adjuvant monotherapy with pembrolizumab. Clinical, paraclinical, and pathological variables, as well as treatment-related adverse events, were recorded.

Results: Two patients with RCC underwent radical nephrectomy. Postoperatively, both were classified as intermediate – high-risk and received immune checkpoint inhibitor therapy with pembrolizumab. During the follow-up period (6–15 months), no recurrence was observed. Both patients experienced mild adverse events, including fatigue and diarrhea.

Conclusion: Adjuvant immunotherapy appears to be well tolerated, with manageable adverse events in the early phase. A larger sample size and longer follow-up are needed to better evaluate its effectiveness in decreasing recurrence and disease progression.