Complex Monitoring of Biochemical and Radionuclide Parameters in Patients with Metastatic Renal Cell Carcinoma during Immunotherapy.

Study Objective: To study the effectiveness of complex monitoring of the kidney function, based on biochemical and radionuclide methods in patients with metastatic renal cell carcinoma (mRCC).

Materials and Methods: 41 mRCC patients after nephrectomy received nivolumab ( n = 23) and interferon- α ( n = 18) from 2015 to 2017. At baseline and 2 months after, all patients underwent blood chemistry, urinalysis, Rehberg test, and ELISA to determine serum levels of IL-17A, TGF- β , and erythropoietin. The monitoring of the renal function and urodynamics by complex renal scintigraphy (CRS) was used for all patients using a dual-detector gamma camera and simultaneous data recording in 2 projections. The interpretation of CRS data used the original SENS CRS technology.

Study Results: Statistically significant correlations were established between IL-17A, TGF- β , and D (excretion rate of 99mTc-technephore from the parenchyma) and Rnfsc (a stable sign of nephrosclerosis), respectively. A significant correlation was established between the parameters of the complex functional monitoring with the prognosis for the risk of renal failure (RF) and efficacy of immunotherapy in mRCC.

Conclusions: All mRCC patients after nephrectomy were recommended to undergo biochemical monitoring with inclusion of TGF- β and IL-17A, as well as radionuclide monitoring (CRS) to determine the RF risk at an early stage.