For certain patients with advanced kidney cancer, it might be better to take the watch-and-wait approach rather than start immediate treatment, according to new research published in The Lancet Oncology.

In the beginning of the study and then at regular intervals, 52 patients with advanced kidney cancer had a CT scan of their chest, abdomen and pelvis for the researchers to determine the tumor burden and the time it took for the disease to progress.

“This trial was conducted prior to patients receiving immunotherapy drugs,” lead author Professor Brian Rini from the department of hematology and oncology at Cleveland Clinic Taussig Cancer Institute, told HCB News.
The patients were followed for an average of 38.1 months, and the researchers found that 29 patients who had two or fewer organs affected by the disease and one or no risk factors were on active surveillance approximately three times longer than the other patients, 22.2 months compared to 8.4 months.

Results also showed that 43 patients had disease progression during the study, and 37 of them started systemic therapy. Before starting systemic therapy, 20 continued active surveillance for 15.8 more months.

Their quality of life, anxiety and depression did not significantly change, which, according to the announcement, suggests that living with untreated cancer did not cause psychological harm in the patients.

“[Active surveillance] could spare them the inconvenience and debilitating side effects of aggressive treatments for about a year, and in some cases several years, without worsening anxiety and depression,” said Rini.

He acknowledges that there are some risks with active surveillance. “Risks are progression of cancer including in the [central nervous system] as happened in two patients,” he said. “With just 50 people involved in our trial, the risk and benefits of the approach will need to be studied in a larger group of patients.”

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