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Redefining the Role of Cytoreductive Nephrectomy in RCC

Brandon Scalea
Published: Friday, Nov 09, 2018

Peter E. Clark, MD

Peter E. Clark, MD

The addition of cytoreductive nephrectomy to sunitinib (Sutent) did not provide a survival benefit in patients with metastatic renal cell carcinoma (RCC), according to findings from the phase III CARMENA trial. The issue now, explained Peter E. Clark, MD, is how to integrate these findings into established paradigms.

Results of the study showed that the median overall survival (OS) was 18.4 months for patients who received sunitinib alone compared with 13.9 months for those who received surgery followed by sunitinib (HR, 0.89; 95% CI, 0.71-1.10).

The TKI produced similar median OS outcomes for patients with intermediate (23.4 vs 19.0 months; HR, 0.92; 95% CI, 0.68-1.24) and poor prognosis (13.3 vs 10.2 months; HR, 0.85; 95% CI, 0.62-1.17). Patients with good prognosis were not eligible for trial enrollment.

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