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KIDNEY CANCER

Cytoreductive nephrectomy: questions remain after CARMENA

Nature Reviews Urology volume 15, pages 530–532 (2018)Cite this article

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Cytoreductive nephrectomy, a standard approach for de novo metastatic renal cell carcinoma in the era of cytokine therapy, has been upheld during the age of targeted therapy on the basis of retrospective data. Now, the first level I prospective data from the CARMENA and SURTIME trials challenge this standard.

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Fig. 1: Proposed ‘CARMENA-like’ clinical trial designs.

References

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

    Article  PubMed  Google Scholar 

  2. Hanna, N. et al. Survival analyses of patients with metastatic renal cancer treated with targeted therapy with or without cytoreductive nephrectomy: a national cancer data base study. J. Clin. Oncol. 34, 3267–3275 (2016).

    Article  PubMed  PubMed Central  Google Scholar 

  3. Bex, A. et al. Immediate versus deferred cytoreductive nephrectomy (CN) in patients with synchronous metastatic renal cell carcinoma (mRCC) receiving sunitinib. Ann. Oncol. 28, v605–v649 (2017).

    Article  Google Scholar 

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

  5. Motzer, R. J. et al. Interferon-alfa as a comparative treatment for clinical trials of new therapies against advanced renal cell carcinoma. J. Clin. Oncol. 20, 289–296 (2002).

    Article  PubMed  CAS  Google Scholar 

  6. Heng, D. Y. et al. Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study. J. Clin. Oncol. 27, 5794–5799 (2009).

    Article  PubMed  CAS  Google Scholar 

  7. Heng, D. Y. 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).

    Article  PubMed  Google Scholar 

  8. Culp, S. H. et al. Can we better select patients with metastatic renal cell carcinoma for cytoreductive nephrectomy? Cancer 116, 3378–3388 (2010).

    Article  PubMed  Google Scholar 

  9. Bhindi, B. et al. Comparative survival following initial cytoreductive nephrectomy versus initial targeted therapy for metastatic renal cell carcinoma. J. Urol. https://doi.org/10.1016/j.juro.2018.03.077 (2018).

  10. Barata, P. C. & Rini, B. I. Treatment of renal cell carcinoma: current status and future directions. CA Cancer J. Clin. 67, 507–524 (2017).

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, University of Southern California, Los Angeles, CA, USA

    Sumeet Bhanvadia

  2. Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA

    Sumanta K. Pal

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  1. Sumeet Bhanvadia
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  2. Sumanta K. Pal
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Correspondence to Sumanta K. Pal.

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The authors declare no competing interests.

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Bhanvadia, S., Pal, S.K. Cytoreductive nephrectomy: questions remain after CARMENA. Nat Rev Urol 15, 530–532 (2018). https://doi.org/10.1038/s41585-018-0064-3

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