Chemotherapy halves the risk of a rare form of kidney cancer returning following surgery, according to the findings of a major trial reported today.
The patients, with cancer of the ureter and renal pelvis, who received chemotherapy within three months of surgery had an increased chance of living cancer free for three years or more, researchers said.
The rare cancer is often diagnosed at a late stage and more than half of patients die, but the POUT trial, led by The Institute of Cancer Research, London, and the Lancashire Teaching Hospitals NHS Foundation Trust, found that treating ureter and renal pelvis cancer patients with platinum-based chemotherapy after surgery reduced the risk of dying or returning by 55%.
The trial involved 261 people with cancer of the ureter and renal pelvis and assessed the benefit of giving people four cycles of a combination of two chemotherapies compared with the current standard of treatment, where patients are actively monitored to spot signs of their cancer coming back after having surgery.
The results, published in The Lancet, found that 71% of patients given chemotherapy survived for three years or more after joining the trial and the disease did not return. This compares with 46% of patients who were on surveillance.
Professor Emma Hall, professor of oncology clinical trials at The Institute of Cancer Research, London, co-ordinator of the study, said: “Our clinical trial has found a considerable benefit of giving chemotherapy to people with cancers that start in the tube leading from the kidney to the bladder – cutting the risk of dying or the disease coming back after surgery by more than half.
“Giving chemotherapy after surgery could give people with this rare form of cancer years more to spend quality time with their families. The results of our study are set to change clinical practice in the UK and internationally, and I’m hopeful that patients will start benefiting very soon.”
Dr Rachel Shaw, Research Information Manager at Cancer Research UK, added: “Thanks to this practice-changing trial, we now have more insight into the best way to treat this rare type of kidney cancer. We hope to see this adopted as the standard treatment in the near future, giving patients the best chance of beating the disease.”
The team now plans to study the benefit of adding immunotherapy or targeted treatment to chemotherapy in this form of the disease.
Lancet 6 March 2020
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