News & Views | Published:

KIDNEY CANCER

The role of nephrectomy in metastatic renal cell carcinoma

Nature Reviews Nephrology (2018) | Download Citation

Cytoreductive nephrectomy is the current treatment paradigm for metastatic renal cell carcinoma (RCC). However, the introduction of targeted therapies has dramatically changed the treatment landscape and may limit the role of nephrectomy in this disease. The recent CARMENA trial supports initial medical treatment of patients with RCC and synchronous metastases.

Access optionsAccess options

Rent or Buy article

Get time limited or full article access on ReadCube.

from $8.99

All prices are NET prices.

References

  1. 1.

    Flanigan, R. C. et al. Cytoreductive nephrectomy in patients with metastatic renal cancer: a combined analysis. J. Urol. 171, 1071–1076 (2004).

  2. 2.

    Motzer, R. J. et al. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N. Engl. J. Med. 356, 115–124 (2007).

  3. 3.

    Mejean, A. et al. Sunitinib alone or after nephrectomy in metastatic renal-cell carcinoma. N. Engl. J. Med. https://doi.org/10.1056/NEJMoa1803675 (2018).

  4. 4.

    Bex, A. et al. Immediate versus deferred cytoreductive nephrectomy in patients with synchronous metastatic renal cell carcinoma (mRCC) receiving sunitinib (EORTC 30073 SURTIME) [abstract LBA35]. Ann. Oncol. 28 (suppl. 5), v605–v649 (2017).

  5. 5.

    Heng, D. Y. C. et al. Cytoreductive nephrectomy in patients with synchronous metastases from renal cell carcinoma: results from the International Metastatic Renal Cell Carcinoma Database Consortium. Eur. Urol. 66, 704–710 (2014).

  6. 6.

    Harshman, L. C. et al. Conditional survival of patients with metastatic renal-cell carcinoma treated with VEGF-targeted therapy: a population-based study. Lancet Oncol. 13, 927–935 (2012).

  7. 7.

    Choueiri, T. K. et al. Cabozantinib versus sunitinib as initial therapy for metastatic renal cell carcinoma of intermediate or poor risk (Alliance A031203 CABOSUN randomised trial): progression-free survival by independent review and overall survival update. Eur J. Cancer 94, 115–125 (2018).

  8. 8.

    Motzer, R. J. et al. Nivolumab plus ipilimumab versus sunitinib in advanced renal-cell carcinoma. N. Engl J. Med. 378, 1277–1290 (2018).

Download references

Author information

Affiliations

  1. Hannover Medical School, Hannover, Germany

    • Viktor Grünwald
  2. The Netherlands Cancer Institute, Amsterdam, Netherlands

    • Axel Bex

Authors

  1. Search for Viktor Grünwald in:

  2. Search for Axel Bex in:

Competing interests

V.G. reports grants, personal fees and non-financial support from Bristol-Myers Squibb (BMS), grants, personal fees and non-financial support from Merck Sharp and Dohme (MSD), personal fees and non-financial support from Roche, personal fees and non-financial support from Novartis, grants and personal fees from Pfizer, grants and personal fees from AstraZeneca, personal fees from Eisai, personal fees and non-financial support from Ipsen, personal fees from EUSA Pharma and personal fees from Cerulean. A.B. reports advisory boards from Pfizer, BMS, Ipsen, Roche and Genentech. He is the principle investigator of SURTIME and received a research grant from Pfizer and the European Organisation for Research and Treatment of Cancer (EORTC).

Corresponding author

Correspondence to Viktor Grünwald.

About this article

Publication history

Published

DOI

https://doi.org/10.1038/s41581-018-0041-3