Analysis of the efficiency of comprehensive rehabilitation of patients undergoing immunotherapy for kidney cancer

Objective: to evaluate the effectiveness of comprehensive rehabilitation programs in patients with renal cell carcinoma(RCC) during immunotherapy. Materials and methods. The study included 85 patients with RCC who received immunotherapy with nivolumab or pembrolizumab from 2021 to 2023. In the main group (n=43), patients participated in a comprehensive rehabilitation program. The control group (n=42) included patients who did not participate in the rehabilitation program. The study was conducted at the Department of Antitumor Drug Therapy of Clinical Hospital No. 1 of JSC MEDSI Group of Companies. Nivolumab therapy 400 mg once every 28 days was administered to 62 patients (72.9 %), the remaining 23 participants (27.1 %) received pembrolizumab therapy 400 mg once every 42 days. The immune-mediated tumor response was assessed according to iRECIST criteria every 6 courses of treatment or in case of signs of clinical progression, adverse events were assessed according to the CTCAE v5.0 scale. Patients’ quality of life was assessed using the EORTC QLQ C30 questionnaire (the results were interpreted on a scale from 0 to 100 points, data were collected using a questionnaire), nutritional risk was assessed using the NRS-2002 questionnaire. The mental sphere was assessed jointly by an oncologist and a psychologist. Results. Disease stabilization was recorded in 25 (58.1 %) patients in the main group and in 22 (52.3 %) patients in the control group; the incidence of disease progression in both groups was comparable: 13 (30.2 %) cases in the main group and 15 (35.7 %) cases in the control group. No adverse events (AEs) of grade IV according to CTCAE 5.0 were recorded during the study period. All identified AEs were of grades I–II. The most frequent grade I–II AEs were asthenia, laboratory-confirmed hypothyroidism, and gastrointestinal disorders. Conclusion. The program of comprehensive rehabilitation of patients with the inclusion of physical methods, magnetic therapy,and nutritional support significantly improves the quality of life, physical and psychological state of patients during and after immuno-oncological treatment.