2024
72 Impact of microbiome modulation on serum cytokine profile in a randomized, phase I trial of cabozantinib/nivolumab (cabo/nivo) with or without CBM588 in pts with metastatic renal cell carcinoma (mRCC)
Li Y, Ebrahimi H, Meza L, Malhotra J, Li X, Dizman N, Dorff T, Frankel P, Llamas-Quitiquit M, Hsu J, Zengin Z, Alcantara M, Castro D, Mercier B, Chawla N, Chehrazi-Raffle A, Barragan-Carrillo R, Gillece J, Trent J, Lee P, Parks T, Takahashi M, Hayashi A, Caporaso J, Lee K, Tripathi A, Pal S. 72 Impact of microbiome modulation on serum cytokine profile in a randomized, phase I trial of cabozantinib/nivolumab (cabo/nivo) with or without CBM588 in pts with metastatic renal cell carcinoma (mRCC). The Oncologist 2024, 29: s36-s37. PMCID: PMC11301871, DOI: 10.1093/oncolo/oyae181.059.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaSerum cytokine profilesCytokine profileClinical outcomesCD8-positive subsetGranulocyte-macrophage colony stimulating factorLevels of IL-12Poor-risk diseasePhase I trialRenal cell carcinomaCirculating cytokine levelsWilcoxon matched-pairs testLevels of cytokinesColony stimulating factorFlow cytometric analysisMatched-pairs testSarcomatoid histologySarcomatoid featuresSystemic immunomodulationCell carcinomaI trialClear cellCytokine levelsInterferon-gIL-1377 Impact of CBM588 on gut microbiome composition and dysbiosis in patients receiving frontline immune checkpoint inhibitor (ICI) combinations for metastatic renal cell carcinoma (mRCC)
Dizman N, Ebrahimi H, Barragan-Carrillo R, Meza L, Bergerot P, Dorff T, BSc J, Zengin Z, Castro D, Chehrazi-Raffle A, Triphathi A, Trent J, Takahashi M, Oka K, Higashi S, Caporaso G, Lee K, Pal S. 77 Impact of CBM588 on gut microbiome composition and dysbiosis in patients receiving frontline immune checkpoint inhibitor (ICI) combinations for metastatic renal cell carcinoma (mRCC). The Oncologist 2024, 29: s5-s5. PMCID: PMC11301884, DOI: 10.1093/oncolo/oyae181.007.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaImmune checkpoint inhibitorsStandard of careGut microbiome compositionStandard of care cohortMicrobiome compositionGut dysbiosisClinical outcomesClinically relevant microbial speciesCompared gut microbiome diversityCell metastatic renal cell carcinomaRandomized phase I clinical trialClinically relevant speciesAssociated with ICI responseStandard of care regimensRelevant microbial speciesGut microbiome diversityRatio of Firmicutes/BacteroidetesPhase I clinical trialPhase III studyBaseline to weekAnalyzed stool samplesFirst-line treatmentRenal cell carcinomaBeta diversityCabozantinib and nivolumab with or without live bacterial supplementation in metastatic renal cell carcinoma: a randomized phase 1 trial
Ebrahimi H, Dizman N, Meza L, Malhotra J, Li X, Dorff T, Frankel P, Llamas-Quitiquit M, Hsu J, Zengin Z, Alcantara M, Castro D, Mercier B, Chawla N, Chehrazi-Raffle A, Barragan-Carrillo R, Jaime-Casas S, Govindarajan A, Gillece J, Trent J, Lee P, Parks T, Takahashi M, Hayashi A, Kortylewski M, Caporaso J, Lee K, Tripathi A, Pal S. Cabozantinib and nivolumab with or without live bacterial supplementation in metastatic renal cell carcinoma: a randomized phase 1 trial. Nature Medicine 2024, 30: 2576-2585. PMID: 38942995, PMCID: PMC11405272, DOI: 10.1038/s41591-024-03086-4.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaProgression-free survivalRenal cell carcinomaCell carcinomaToxicity profileAbundance of Bifidobacterium sppControl armTreatment-naive participantsFirst-line treatmentPhase 1 studyPhase 1 trialSarcomatoid componentOpen-labelHistological confirmationPrimary endpointSecondary endpointsNo significant differenceClear cellNivolumabInvestigator-initiatedClinical outcomesCabozantinibClinical activityStool samplesStudy armsRenal Cell Carcinoma of Variant Histology: New Biologic Understanding Leads to Therapeutic Advances.
Salgia N, Zengin Z, Pal S, Dizman N. Renal Cell Carcinoma of Variant Histology: New Biologic Understanding Leads to Therapeutic Advances. American Society Of Clinical Oncology Educational Book 2024, 44: e438642. PMID: 38776514, PMCID: PMC11235416, DOI: 10.1200/edbk_438642.Peer-Reviewed Original ResearchConceptsRenal cell carcinomaPapillary renal cell carcinomaBiology of renal cell carcinomaHistology renal cell carcinomaPatient populationRenal cell carcinoma histologyMetastatic renal cell carcinomaRenal cell carcinoma casesOptimization of treatment regimensNon-clear cellPrecision oncology approachesDiagnosed solid tumorsSarcomatoid dedifferentiationVariant histologyRare subtypeHistopathological subtypesCell carcinomaSolid tumorsClinical featuresTreatment regimensClinical findingsOncology approachesTherapeutic advancesTherapeutic approachesUnique pathogenesesImpact of CBM588 on gut microbiome composition and dysbiosis in patients receiving frontline immune checkpoint inhibitor (ICI) combinations for metastatic renal cell carcinoma (mRCC).
Dizman N, Ebrahimi H, Barragán Carrillo R, Meza L, Bergerot P, Dorff T, Hsu J, Zengin Z, Castro D, Chehrazi-Raffle A, Tripathi A, Trent J, Takahashi M, Oka K, Higashi S, Caporaso G, Lee K, Pal S. Impact of CBM588 on gut microbiome composition and dysbiosis in patients receiving frontline immune checkpoint inhibitor (ICI) combinations for metastatic renal cell carcinoma (mRCC). Journal Of Clinical Oncology 2024, 42: 4550-4550. DOI: 10.1200/jco.2024.42.16_suppl.4550.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaImmune checkpoint inhibitorsStandard of careStandard of care cohortGut microbiome compositionMicrobiome compositionClinical outcomesCell metastatic renal cell carcinomaRandomized phase I clinical trialGut dysbiosisAssociated with ICI responseStandard of care regimensClinically relevant microbial speciesCompared gut microbiome diversityPhase I clinical trialClinically relevant speciesPhase III studyRelevant microbial speciesBaseline to weekFirst-line treatmentGut microbiome diversityRatio of Firmicutes/BacteroidetesRenal cell carcinomaWilcoxon matched pairs testAnalyzed stool samplesPrevalence of Dietary Modification and Supplement Use in Patients with Metastatic Renal Cell Carcinoma Receiving Systemic Therapy
Ebrahimi H, Battle D, Salgia N, Zengin Z, Dizman N, Meza L, Bergerot C, Barragan-Carrillo R, Hsu J, Castro D, Mercier B, Chawla N, Li X, Tripathi A, Liu S, Chehrazi-Raffle A, Vaishampayan U, Staehler M, Pal S. Prevalence of Dietary Modification and Supplement Use in Patients with Metastatic Renal Cell Carcinoma Receiving Systemic Therapy. Nutrients 2024, 16: 1630. PMID: 38892563, PMCID: PMC11174627, DOI: 10.3390/nu16111630.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaRenal cell carcinomaCell carcinomaDietary modificationSupplement useDiagnosis of renal cell carcinomaFirst-line treatmentSupplement usageSystemic therapyCombination therapyAntineoplastic therapyKetogenic dietCarcinomaCancer therapyMediterranean dietPhysician-patient dialoguePatientsTherapyCancer treatmentGrowing body of evidenceBody of evidenceDietary changesCancerCancer diagnosisCannabidiolImpact of Synchronous versus Metachronous Metastasis on Outcomes in Patients with Metastatic Renal Cell Carcinoma Treated with First-line Immune Checkpoint Inhibitor–based Combinations
Gebrael G, Meza L, Li X, Zengin Z, Sayegh N, Ebrahimi H, Tripathi N, Castro D, Mercier B, Barragan-Carrillo R, Li H, Chehrazi-Raffle A, Swami U, Tripathi A, Agarwal N, Maughan B, Pal S. Impact of Synchronous versus Metachronous Metastasis on Outcomes in Patients with Metastatic Renal Cell Carcinoma Treated with First-line Immune Checkpoint Inhibitor–based Combinations. European Urology Focus 2024 PMID: 38580524, DOI: 10.1016/j.euf.2024.03.006.Peer-Reviewed Original ResearchTime to treatment failureDisease control rateRenal cell carcinomaSynchronous metastasesMetachronous metastasesOverall survivalMetachronous metastatic renal cell carcinomaMedian time to treatment failureICI-based combination therapyAssociated with worse OSMetastatic renal cell carcinomaFirst-line immunotherapyICI-based combinationsRenal cell carcinoma diagnosisDiagnosis of kidney cancerHypothesis-generating studyMedian OSMetachronous groupPoor OSTreatment failureCombination therapyMetastasis onsetCell carcinomaSurvival outcomesClinical outcomesAssociation between thymectomy and incidence of renal cell carcinoma (RCC).
Barragan-Carrillo R, Ebrahimi H, Chawla N, Salgia N, Castro D, Chehrazi-Raffle A, Dizman N, Hsu J, Meza L, Zengin Z, LeVee A, Tripathi A, Dorff T, Bergerot C, Bergerot P, Eilber K, Dallas K, Pal S. Association between thymectomy and incidence of renal cell carcinoma (RCC). Journal Of Clinical Oncology 2024, 42: 371-371. DOI: 10.1200/jco.2024.42.4_suppl.371.Peer-Reviewed Original ResearchRenal cell carcinomaIncidence of nephrectomyIncidence of renal cell carcinomaMedian age of patientsFrequency of nephrectomyAge of patientsT cell productionProportion of patientsRate of nephrectomyFisher's exact testGeneral populationAge-matched populationICD-9/10 codesPopulation-based cohortPopulation-based studyImmunogenic cancerPrior thymectomyChi-square testCell carcinomaMedian ageSurgical interventionNephrectomyThymectomyExact testOSHPD databaseEvolution of the functionality of microbial communities in patients with metastatic renal cell carcinoma (mRCC) receiving cabozantinib (cabo)/nivolumab (nivo) with or without CBM588: A randomized clinical trial.
Ebrahimi H, Meza L, Lee K, Malhotra J, Alcantara M, Zengin Z, Dizman N, Hsu J, Llamas-Quitiquit M, Castro D, Mercier B, Barragan-Carrillo R, Chawla N, Li X, Liu S, Chehrazi-Raffle A, Dorff T, Frankel P, Tripathi A, Pal S. Evolution of the functionality of microbial communities in patients with metastatic renal cell carcinoma (mRCC) receiving cabozantinib (cabo)/nivolumab (nivo) with or without CBM588: A randomized clinical trial. Journal Of Clinical Oncology 2024, 42: 460-460. DOI: 10.1200/jco.2024.42.4_suppl.460.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaMetabolic pathwaysClinical outcomesAnnotated open reading framesFunction of microbial communitiesMetatranscriptomic sequencing dataWhole metagenome sequencingOpen reading frameGut microbial functionsGut microbiome functionsResponse rate to sorafenibExperimental armElectron transfer chainCancer cell typesAssociated with clinical outcomesRenal cell carcinomaReading frameSequence dataTaxonomic profilesBiosynthesis pathwayMetagenomic sequencingMicrobiome functionMicrobial functionsMolecular functionsRandomized clinical trialsCombination nivolumab and ipilimumab with and without camu camu in first-line treatment of metastatic renal cell carcinoma (mRCC).
Barragan-Carrillo R, Chawla N, Salgia N, Meza L, Zengin Z, Li X, Dizman N, Ebrahimi H, Hsu J, Castro D, Mercier B, Dorff T, Tripathi A, Bergerot C, Bergerot P, Chehrazi-Raffle A, Pal S. Combination nivolumab and ipilimumab with and without camu camu in first-line treatment of metastatic renal cell carcinoma (mRCC). Journal Of Clinical Oncology 2024, 42: tps491-tps491. DOI: 10.1200/jco.2024.42.4_suppl.tps491.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaImmune checkpoint inhibitionBaseline to weekFirst-line treatmentClinical responsePoor-risk metastatic renal cell carcinomaFirst-line treatment of metastatic renal cell carcinomaTreatment of metastatic renal cell carcinomaCombination of immune checkpoint inhibitionEfficacy of anti-PD1 therapyCombination immune checkpoint inhibitionDual immune checkpoint inhibitionCD8+ T cellsAnti-PD1 therapyImmune-related toxicitiesProgression-free survivalWeeks of therapyReduced tumor sizeTyrosine kinase inhibitorsSingle-center trialRenal cell carcinomaClear-cell RCCMouse tumor modelsOne-sided type I errorCombination nivolumab
2023
Genomic and Transcriptomic Characteristics of Tumors of Patients with Metastatic Clear Cell Renal Cell Carcinoma Clinically Benefiting from First-Line Treatment with Ipilimumab Plus Nivolumab
Tripathi N, Meza L, Sayegh N, Govindarajan A, Byron S, Zhang J, Chigarira B, Jo Y, Zengin Z, Li H, Gebrael G, Desai A, Agarwal N, Swami U, Maughan B, Pal S. Genomic and Transcriptomic Characteristics of Tumors of Patients with Metastatic Clear Cell Renal Cell Carcinoma Clinically Benefiting from First-Line Treatment with Ipilimumab Plus Nivolumab. Kidney Cancer 2023, 7: 137-145. DOI: 10.3233/kca-230011.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaClear cell metastatic renal cell carcinomaClinical benefit groupRenal cell carcinomaClinical benefitNivolumab therapyCell carcinomaPoor-risk metastatic renal cell carcinomaMetastatic clear cell renal cell carcinomaBenefit groupClear cell renal cell carcinomaFirst-line ipilimumabIMDC risk scoresFirst-line treatmentCell renal cell carcinomaAlteration frequencyChi-square testMRCC patientsStable diseaseComplete responsePartial responseSystemic therapyLine treatmentInflammatory pathwaysTumor-specific gene expressionAssociation Between Time-of-Day of Immune Checkpoint Blockade Administration and Outcomes in Metastatic Renal Cell Carcinoma
Dizman N, Govindarajan A, Zengin Z, Meza L, Tripathi N, Sayegh N, Castro D, Chan E, Lee K, Prajapati S, Feng M, Loo V, Pace M, O'Brien S, Bailey E, Barragan-Carrillo R, Chehrazi-Raffle A, Hsu J, Li X, Agarwal N, Pal S. Association Between Time-of-Day of Immune Checkpoint Blockade Administration and Outcomes in Metastatic Renal Cell Carcinoma. Clinical Genitourinary Cancer 2023, 21: 530-536. PMID: 37495481, DOI: 10.1016/j.clgc.2023.06.004.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaObjective response rateTreatment failureRenal cell carcinomaHazard ratioOverall survivalCell carcinomaMultivariate analysisHigh Cut-OffNivolumab/ipilimumabProspective Randomized StudyBaseline characteristicsRandomized studyClinical outcomesMedian timePreclinical evidenceUnivariate analysisPatientsResponse rateImmune systemInfusion timeStatistical significanceOutcomesCarcinomaInfusionEffect of CBM588 in combination with cabozantinib plus nivolumab for patients (pts) with metastatic renal cell carcinoma (mRCC): A randomized clinical trial.
Ebrahimi H, Meza L, Lee K, Malhotra J, Alcantara M, Zengin Z, Dizman N, Govindarajan A, Hsu J, Llamas-Quitiquit M, Chawla N, Castro D, Mercier B, Liu S, Chehrazi-Raffle A, Dorff T, Frankel P, Li X, Pal S, Tripathi A. Effect of CBM588 in combination with cabozantinib plus nivolumab for patients (pts) with metastatic renal cell carcinoma (mRCC): A randomized clinical trial. Journal Of Clinical Oncology 2023, 41: lba104-lba104. DOI: 10.1200/jco.2023.41.17_suppl.lba104.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaProgression-free survivalTyrosine kinase inhibitorsPrimary endpointClinical outcomesStool specimensDual immune checkpoint inhibitorsMedian progression-free survivalImproved progression-free survivalOne-sided type I errorBifidobacterium sppGrade 3/4 toxicitiesImmune checkpoint inhibitorsStudy's primary endpointWeeks of treatmentDose/scheduleRandomized clinical trialsRenal cell carcinomaEligible ptsPo bidSystemic immunomodulationCheckpoint inhibitorsSecondary endpointsLine therapyMetastatic diseaseAssessment of short-chain fatty acid (SCFA) and circulating cytokine trends in a clinical trial of nivolumab/ipilimumab and CBM588 in metastatic renal cell carcinoma (mRCC).
Dizman N, Pathak K, Alcantara M, Meza L, Bergerot P, Willey M, Dorff T, Hsu J, Zengin Z, Castro D, Ebrahimi H, Chehrazi-Raffle A, Tripathi A, Trent J, Takahashi M, Oka K, Higashi S, Kortylewski M, Pirrotte P, Pal S. Assessment of short-chain fatty acid (SCFA) and circulating cytokine trends in a clinical trial of nivolumab/ipilimumab and CBM588 in metastatic renal cell carcinoma (mRCC). Journal Of Clinical Oncology 2023, 41: 4556-4556. DOI: 10.1200/jco.2023.41.16_suppl.4556.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaNivolumab/ipilimumabObjective response rateShort-chain fatty acidsPlasma short-chain fatty acidsImmune checkpoint blockadeCheckpoint blockadeCytokine levelsSCFA levelsClinical trialsRandomized phase I clinical trialSarcomatoid Metastatic Renal Cell CarcinomaPhase I clinical trialStool SCFA levelsAcid levelsTreatment-naïve patientsAltered amino acid metabolismRenal cell carcinomaIpilimumab armNaïve patientsButyric acid levelsSerum cytokinesClinical outcomesCell carcinomaBiologic rationaleAssociation between intra-tumoral microbiome and clinical benefit (CB) from immunotherapy (IO) in patients with metastatic renal cell carcinoma (mRCC).
Meza L, Choi Y, Zhang J, Dizman N, Zengin Z, Ebrahimi H, Barragan-Carrillo R, Hsu J, Chawla N, Chehrazi-Raffle A, Tripathi A, Castro D, Mercier B, Govindarajan A, Chan A, Schork N, Byron S, Pal S. Association between intra-tumoral microbiome and clinical benefit (CB) from immunotherapy (IO) in patients with metastatic renal cell carcinoma (mRCC). Journal Of Clinical Oncology 2023, 41: 4561-4561. DOI: 10.1200/jco.2023.41.16_suppl.4561.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaClinical benefitLine immunotherapyMicrobial diversityNivolumab/ipilimumabStart of immunotherapyBacterial diversityClear cell histologyPD-L1 expressionRenal cell carcinomaRelative abundanceAvailable RNA sequencing dataRelative microbial abundanceParaffin-embedded samplesRNA sequencing dataRNA-seq readsCell histologyCommon regimenMedian ageLine treatmentCell carcinomaPoor riskShannon diversity indexRCC tumorsImmunotherapyUltrasensitive Circulating Tumor DNA Pilot Study Distinguishes Complete Response and Partial Response With Immunotherapy in Patients With Metastatic Renal Cell Carcinoma
Chehrazi-Raffle A, Muddasani R, Dizman N, Hsu J, Meza L, Zengin Z, Malhotra J, Chawla N, Dorff T, Contente-Cuomo T, Dinwiddie D, McDonald B, McDaniel T, Trent J, Baehner F, Murtaza M, Pal S. Ultrasensitive Circulating Tumor DNA Pilot Study Distinguishes Complete Response and Partial Response With Immunotherapy in Patients With Metastatic Renal Cell Carcinoma. JCO Precision Oncology 2023, 7: e2200543. PMID: 37027813, PMCID: PMC10309555, DOI: 10.1200/po.22.00543.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaPartial responseComplete responseVariant allele fractionRenal cell carcinomaCell carcinomaCtDNA analysisImmune checkpoint inhibitor therapyCheckpoint inhibitor therapyDiscontinuation of immunotherapyDepth of responseICI therapyNivolumab monotherapyEligible patientsRadiographic progressionInhibitor therapyPeripheral bloodDisease progressionCtDNA assessmentSubsequent progressionPatientsMultiple indicationsSingle time pointPatient-specific mutationsSecondary objectiveTwelve-Month Follow-up of the Immune Response After COVID-19 Vaccination in Patients with Genitourinary Cancers: A Prospective Cohort Analysis
Meza L, Zengin Z, Salgia S, Malhotra J, Karczewska E, Dorff T, Tripathi A, Ely J, Kelley E, Mead H, Hsu J, Dizman N, Salgia N, Chawla N, Chehrazi-Raffle A, Muddasani R, Govindarajan A, Rock A, Liu S, Salgia R, Trent J, Altin J, Pal S. Twelve-Month Follow-up of the Immune Response After COVID-19 Vaccination in Patients with Genitourinary Cancers: A Prospective Cohort Analysis. The Oncologist 2023, 28: e748-e755. PMID: 36971500, PMCID: PMC10485287, DOI: 10.1093/oncolo/oyad067.Peer-Reviewed Original ResearchConceptsCOVID-19 vaccinationGenitourinary cancersRenal cell carcinomaBooster doseCell carcinomaImmune responseBlood samplesSevere acute respiratory syndrome coronavirus 2Acute respiratory syndrome coronavirus 2T-cell receptor sequencingRespiratory syndrome coronavirus 2Baseline blood samplesMajority of patientsMinority of patientsProspective cohort analysisSyndrome coronavirus 2Twelve-month followAntibody titer analysisCOVID-19 vaccineSeroconversion ratesMedian ageUrothelial cancerCoronavirus 2Prostate cancerCohort analysisEvaluation of eligibility criteria in contemporary renal cell carcinoma based on ASCO-FCR recommendations.
Prajapati S, Feng M, Castro D, Lee K, Chan E, Sehgal I, Patel J, O'Dell A, Zengin Z, Li X, Chehrazi-Raffle A, Dizman N, Tripathi A, Rock A, Liu S, Mercier B, Meza L, Philip E, Dorff T, Pal S. Evaluation of eligibility criteria in contemporary renal cell carcinoma based on ASCO-FCR recommendations. Journal Of Clinical Oncology 2023, 41: 612-612. DOI: 10.1200/jco.2023.41.6_suppl.612.Peer-Reviewed Original ResearchRestrictive eligibility criteriaEligibility criteriaHCV positivityHIV positivityInclusion criteriaExclusion criteriaExact testClass of therapyReal-world populationRenal cell carcinomaFisher's exact testChi-square testConcurrent malignancyBrain metastasesAdult patientsCell carcinomaCombination therapyPatient populationCancer trialsRCC trialsConsensus statementRadiation therapyClinical OncologyPrognostic toolReal-world settingImpact of race and payor status on patterns of utilization of partial and radical nephrectomy in patients with localized renal cell carcinoma (RCC).
Barragan-Carrillo R, Dallas K, Tripathi A, Govindarajan A, Zengin Z, Meza L, Philip E, Castro D, Chehrazi-Raffle A, Chawla N, Hsu J, Dizman N, Eilber K, Bergerot C, Pal S. Impact of race and payor status on patterns of utilization of partial and radical nephrectomy in patients with localized renal cell carcinoma (RCC). Journal Of Clinical Oncology 2023, 41: 614-614. DOI: 10.1200/jco.2023.41.6_suppl.614.Peer-Reviewed Original ResearchPrevalence of dietary modification and supplement use in patients with metastatic renal cell carcinoma (mRCC).
Ebrahimi H, Battle D, Zengin Z, Dizman N, Meza L, Castro D, Govindarajan A, Mercier B, Chawla N, Chehrazi-Raffle A, Tripathi A, Liu S, Vaishampayan U, Staehler M, Pal S. Prevalence of dietary modification and supplement use in patients with metastatic renal cell carcinoma (mRCC). Journal Of Clinical Oncology 2023, 41: 662-662. DOI: 10.1200/jco.2023.41.6_suppl.662.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaRenal cell carcinomaDietary modificationSupplement useCell carcinomaSupplement intakeKetogenic dietSupplement usageActive systemic therapyNivolumab/ipilimumabFirst-line treatmentMajority of patientsT-testPatient advocacy groupsChi-square testStudent's t-testClinical trial candidatesOnly patientsSystemic therapyMedian ageAntineoplastic treatmentProspective studyPotential confoundersInclusion criteriaMediterranean diet