Sunitinib alone or after nephrectomy in metastatic renal-cell carcinoma

French researchers spearheaded a Phase III trial to investigate cytoreductive nephrectomy in kidney-cancer patients undergoing targeted therapy. While the surgery is an accepted standard of care to treat metastatic renal-cell carcinoma for certain patients, its adoption in the setting of targeted therapy is largely unexplored.

French researchers spearheaded a Phase III trial to investigate cytoreductive nephrectomy in kidney-cancer patients undergoing targeted therapy. While the surgery is an accepted standard of care to treat metastatic renal-cell carcinoma for certain patients, its adoption in the setting of targeted therapy is largely unexplored. The team rounded up 450 patients for the study, 326 of whom had died by followup at about 51 months. Overall survival, the primary outcome, settled at a mean 13.9 months for participants randomized to nephrectomy followed by standard therapy with sunitinib. Participants assigned to sunitinib only, meanwhile, lived for a mean 18.4 months. Based on the findings, the investigators conclude that sunitinib alone is not inferior to nephrectomy plus sunitinib in patients with metastatic renal-cell carcinoma who are categorized as having intermediate- or poor-risk disease based on the Memorial Sloan Kettering Cancer Center prognostic model. The results conflict with earlier research, though limited, which has pointed to an overall survival benefit with nephrectomy in patients treated with targeted therapies.