Dr. Eber on Takeaways From the CARMENA Trial in mRCC

Paul R. Eber, MD
Published: Thursday, Apr 04, 2019



Paul R. Eber, MD, a urologist at Conrad-Pearson Clinic, discusses takeaways from the CARMENA trial in metastatic renal cell carcinoma (mRCC).

In the phase III CARMENA trial, investigators used the Memorial Sloan Kettering prognostic model. Now, more people use the International Renal Cell Carcinoma Risk Criteria for prognosis, says Eber. However, surgeons tend not rely on these models, but instead focus on whether or not the patient’s tumor is resectable or not according to preoperative lab work and tumor size.

The trial showed that sunitinib (Sutent) alone was noninferior to cytoreductive nephrectomy followed by sunitinib in patients with intermediate- and poor-risk mRCC. Specifically, sunitinib demonstrated comparable median overall survival for patients with intermediate prognosis, at 23.4 versus 19.0 months (HR, 0.92; 95% CI, 0.68-1.24) and poor prognosis, at 13.3 versus 10.2 months (HR, 0.85; 95% CI, 0.62-1.17), respectively. As such, the trial showed the importance of referring patients to medical oncologists, specifically genitourinary medical oncologists, so that they can assess the patient’s risk status before heading to surgery.
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Paul R. Eber, MD, a urologist at Conrad-Pearson Clinic, discusses takeaways from the CARMENA trial in metastatic renal cell carcinoma (mRCC).

In the phase III CARMENA trial, investigators used the Memorial Sloan Kettering prognostic model. Now, more people use the International Renal Cell Carcinoma Risk Criteria for prognosis, says Eber. However, surgeons tend not rely on these models, but instead focus on whether or not the patient’s tumor is resectable or not according to preoperative lab work and tumor size.

The trial showed that sunitinib (Sutent) alone was noninferior to cytoreductive nephrectomy followed by sunitinib in patients with intermediate- and poor-risk mRCC. Specifically, sunitinib demonstrated comparable median overall survival for patients with intermediate prognosis, at 23.4 versus 19.0 months (HR, 0.92; 95% CI, 0.68-1.24) and poor prognosis, at 13.3 versus 10.2 months (HR, 0.85; 95% CI, 0.62-1.17), respectively. As such, the trial showed the importance of referring patients to medical oncologists, specifically genitourinary medical oncologists, so that they can assess the patient’s risk status before heading to surgery.

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