For the first time ever, the Annual EAU Congress went virtual. It took place from the 17th to the 19th of July followed by the EAU20 Theme Week from the 20th to the 27th of July.
Thematic Session 05 reviewed recent evolutions in localized kidney cancer surgery and knowledge. Specifically, different aspects of nephron-sparing surgery were presented including predominance of parenchymal preservation over ischemia time and the different technical evolutions ensuring maximal functional outcomes. In addition, the role of the robotic-assisted approach was illustrated through its application to the treatment of RCC with venous thrombus.
Trends in renal surgery, especially partial nephrectomy, are more and more favouring the use of robotics compared to open approach as reported in the IRON and the BAUS studies (see our selection of EAU20 abstracts on RCC below and this interview with Dr. Larcher). In Video Session 05, new imaging modalities including 3D modelling and augmented reality to enhance the tools and the ergonomics of the robot were reported.
For metastatic cases (mRCC), the paradigm has completely shifted towards combination therapy (IO and TKI or IO and IO), ending the era of single TKI use in the first line of treatment. However, although efficacy has been proven for both strategies, clinical and biological markers for tailored treatment are lacking. Treatment choice should be discussed based on patient profile, expectations as well as sequencing strategies within a multidisciplinary board, as chewed over in Thematic Session 07. A health-related quality-of-life (HRQoL) analysis from the phase III KEYNOTE-426 trial, which demonstrated the efficacy of pembrolizumab plus axitinib over sunitinib alone in the first-line treatment of advanced RCC, was presented as well. Pembrolizumab and axitinib maintained QoL (QLQ-C30, FKSI-DRS and EQ-5D visual analogue scale) compared with sunitinib, despite being a combination treatment (see table 1).
Table 1: Health-related quality-of-life (HRQoL) analysis from KEYNOTE-426
Of note, all scientific content and webcasts are available in the EAU20 Resource Centre.