The future of perioperative therapy in advanced renal cell carcinoma: how can we PROSPER?

Journal Article (Clinical Trial, Phase III;Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Patel, HD; Puligandla, M; Shuch, BM; Leibovich, BC; Kapoor, A; Master, VA; Drake, CG; Heng, DY; Lara, PN; Choueiri, TK; Maskens, D; Singer, EA; Eggener, SE; Svatek, RS; Stadler, WM; Cole, S; Signoretti, S; Gupta, RT; Michaelson, MD; McDermott, DF; Cella, D; Wagner, LI; Haas, NB; Carducci, MA; Harshman, LC; Allaf, ME

Published Date

  • May 2019

Published In

Volume / Issue

  • 15 / 15

Start / End Page

  • 1683 - 1695

PubMed ID

  • 30968729

Pubmed Central ID

  • PMC6595543

Electronic International Standard Serial Number (EISSN)

  • 1744-8301

Digital Object Identifier (DOI)

  • 10.2217/fon-2018-0951


  • eng

Conference Location

  • England