Assessing the Link Between Thymectomy and Nephrectomy in RCC

Regina Barragan-Carrillo, MD, medical oncologist, postdoctoral fellow, Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, discusses an abstract which evaluated the association between thymectomy and incidence of renal cell carcinoma (RCC).

Findings from a large population-based study found there to be significantly higher rates of nephrectomy among patients with RCC who had received prior thymectomy vs the incidence of nephrectomy overall.

Here, Barragan-Carrillo provides an overview on this research.

Transcription:

0:09 | It is very important during the development of the immune system during childhood, and it usually occurs during the teenage years. But in adulthood, the role of the thymectomy was quite unclear. Recently, back in 2023, there was a paper published in the New England Journal of Medicine addressing the role of the thymus in adult life, and what they noticed is that there was an increase in overall mortality in patients who underwent at thymectomy in their adult life, when compared with controls, which were quite surprising results like after having this dogma for the past 200 years. Additionally, they also noticed that there was an increase in the rate of cancer diagnosis, number of cancers per patient and cancer-related mortality in patients who did not have the thymic tissue.

1:06 | It is important to note that these results are secondary malignancies or any other malignancies associated within the thymic tissue. So, I think these results are surprising and even for example, looking at the type cancers that were reported, those did not follow what we classically see worldwide, so that was also an important factor. We have noticed, mostly in the last 15 years, that renal cell carcinoma is a tumor that is highly exquisite to be treated with immunotherapy, mostly standard care is currently based on immune checkpoint inhibitors in combination with another CTLA4 inhibitor or [tyrosine kinase (TKI)]. So it has a very unique biology.

1:53 | This sensitivity to immunotherapy, unlike other neoplasms, does not stem from TME or does not stem from mismatch repair deficiency, but from at least part from a particular tumor microenvironment, which characterized by an important infiltrate of lymphocytes, which exceeded this classical phenotype of immune exhaustion. We saw the connection between those 2, and we asked ourselves the question whether these patients who had had the history of a thymectomy during their adult adult life would be at a higher risk to develop renal malignancies.