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Updated: Jan 26, 2026
A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
The future of perioperative therapy in advanced renal cell carcinoma: how can we PROSPER?
Hiten D Patel1, Maneka Puligandla2, Brian M Shuch3
1Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Abstract:
Patients with high-risk renal cell carcinoma (RCC) experience high rates of recurrence despite definitive surgical resection. Recent trials of adjuvant tyrosine kinase inhibitor therapy have provided conflicting efficacy results at the cost of significant adverse events. PD-1 blockade via monoclonal antibodies has emerged as an effective disease-modifying treatment for metastatic RCC. There is emerging data across other solid tumors of the potential efficacy of neoadjuvant PD-1 blockade, and preclinical evidence supporting a neoadjuvant over adjuvant approach. PROSPER RCC is a Phase III, randomized trial evaluating whether perioperative nivolumab increases recurrence-free survival in patients with high-risk RCC undergoing nephrectomy. The neoadjuvant component, intended to prime the immune system for enhanced efficacy, distinguishes PROSPER from other purely adjuvant studies and permits highly clinically relevant translational studies.
Insights
The PROSPER RCC trial investigates if perioperative nivolumab improves recurrence-free survival for high-risk kidney cancer patients. This approach aims to enhance immune response before surgery, differing from purely adjuvant therapies.
Area of Science:
- Oncology
- Immunotherapy
- Nephrology
Background:
- High-risk renal cell carcinoma (RCC) frequently recurs post-surgery.
- Adjuvant tyrosine kinase inhibitors show mixed results and cause adverse events.
- PD-1 blockade is effective for metastatic RCC and shows promise in neoadjuvant settings.
Purpose of the Study:
- To evaluate if perioperative nivolumab improves recurrence-free survival in high-risk RCC patients undergoing nephrectomy.
- To assess the efficacy of neoadjuvant PD-1 blockade in priming the immune system for enhanced anti-cancer response.
- To enable clinically relevant translational studies on neoadjuvant immunotherapy.
Main Methods:
- Phase III, randomized trial design.
- Perioperative administration of nivolumab (PD-1 blockade).
- Patient population: high-risk renal cell carcinoma undergoing nephrectomy.
Main Results:
- Study is ongoing; results not yet available.
Conclusions:
- Neoadjuvant PD-1 blockade represents a novel strategy for high-risk RCC.
- PROSPER RCC trial will provide critical data on perioperative immunotherapy for kidney cancer.
- Understanding neoadjuvant immunotherapy's role may optimize treatment paradigms for RCC recurrence.
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