The outcome of patients treated with sunitinib prior to planned nephrectomy in metastatic clear cell renal cancer.

@article{Powles2011TheOO,
  title={The outcome of patients treated with sunitinib prior to planned nephrectomy in metastatic clear cell renal cancer.},
  author={T. Powles and C. Blank and S. Chowdhury and S. Horenblas and J. Peters and J. Shamash and N. Sarwar and E. Boleti and A. Sahdev and T. O'brien and D. Berney and L. Beltr{\'a}n and P. Nathan and J. Haanen and A. Bex},
  journal={European urology},
  year={2011},
  volume={60 3},
  pages={
          448-54
        }
}
BACKGROUND The role of cytoreductive nephrectomy in metastatic clear cell renal cell carcinoma (ccRCC) is controversial. OBJECTIVE To determine the outcome of patients with metastatic ccRCC who receive sunitinib prior to planned nephrectomy. DESIGN, SETTING, AND PARTICIPANTS The study combined the data from two prospective phase 2 studies that assessed upfront sunitinib (12-16 wk) prior to nephrectomy in previously untreated patients with metastatic renal cell carcinoma (RCC). Sunitinib was… Expand
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This study suggests that cytoreductive nephrectomy may be effective in primary metastatic renal cell carcinoma patients treated with first-line sunitinib, however, the benefit was modest when correcting for time from diagnosis to sunit inib. Expand
Comparison of Immediate vs Deferred Cytoreductive Nephrectomy in Patients With Synchronous Metastatic Renal Cell Carcinoma Receiving Sunitinib: The SURTIME Randomized Clinical Trial
TLDR
This evidence complements recent data from randomized clinical trials to inform treatment decisions in patients with primary clear cell mRCC requiring sunitinib and may identify patients with inherent resistance to systemic therapy before planned CN. Expand
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TLDR
PatientsPrimary treated with CN survived significantly longer than patients primary treated with systemic therapy or palliation, in all age groups, and CN was an important first-line treatment option in mRCC patients. Expand
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TLDR
The results of this study suggest that cytoreductive nephrectomy may have limited efficacy in patients who experience disease progression following initiation of sunitinib or in patients with poor MSKCC risk. Expand
Nephrectomy improves overall survival in patients with metastatic renal cell carcinoma in cases of favorable MSKCC or ECOG prognostic features.
TLDR
CN improves OS in patients with mRCC, however, this effect does not seem to be significant for the patients in ECOG performance status groups of 2 to 3 or poor MSKCC prognostic group. Expand
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TLDR
Nephrectomy after upfront pazopanib therapy could be performed safely and was associated with good outcomes in patients with intermediate-risk metastatic clear cell renal cancer. Expand
Presurgical sunitinib reduces tumor size and may facilitate partial nephrectomy in patients with renal cell carcinoma.
TLDR
Presurgical sunitinib leads to modest tumor reduction in most primary RCC, and many patients can be subsequently treated with PN with acceptable morbidity and preserved renal function. Expand
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