Ulka Vaishampayan, MD, discusses the shifting role of cytoreductive nephrectomy in renal cell carcinoma.
Ulka Vaishampayan, MD, professor of oncology at Wayne State University, and the chief of the Solid Tumor Program at Barbara Ann Karmanos Cancer Institute, discusses the shifting role of cytoreductive nephrectomy in renal cell carcinoma.
Historically, cytoreductive nephrectomy demonstrated an overall survival benefit in patients with metastatic kidney cancer, explains Vaishampayan. Cytoreductive nephrectomy was considered the first step in the management of patients who resented with primary and metastatic disease and had good performance status, says Vaishampayan.
The CARMENA trial compared cytoreductive nephrectomy with anti-VEGF therapy. Historically, this was looked at with interferon because that was the only treatment available that was previously applicable to the majority of patients. The CARMENA trial showed that with contemporary anti-VEGF therapy, cytoreductive nephrectomy did not appear to have benefit. As a result, the trial caused a paradigm shift in how treatment is approached, concludes Vaishampayan.