TY - JOUR
T1 - Updated European Association of Urology Guidelines Regarding Adjuvant Therapy for Renal Cell Carcinoma
AU - Bex, Axel
AU - Albiges, Laurence
AU - Ljungberg, Börje
AU - Bensalah, Karim
AU - Dabestani, Saeed
AU - Giles, Rachel H.
AU - Hofmann, Fabian
AU - Hora, Milan
AU - Kuczyk, Markus A.
AU - Lam, Thomas B.
AU - Marconi, Lorenzo
AU - Merseburger, Axel S.
AU - Staehler, Michael
AU - Volpe, Alessandro
AU - Powles, Thomas
N1 - Publisher Copyright:
© 2016 European Association of Urology
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - The European Association of Urology Renal Cell Carcinoma (RCC) guidelines panel updated their recommendation on adjuvant therapy in unfavourable, clinically nonmetastatic RCC following the recently reported results of a second randomised controlled phase 3 trial comparing 1-yr sunitinib to placebo for high-risk RCC after nephrectomy (S-TRAC). On the basis of conflicting results from the two available studies, the panel rated the quality of the evidence, the harm-to-benefit ratio, patient preferences, and costs. Finally, the panel, including representatives from a patient advocate group (International Kidney Cancer Coalition) voted and reached a consensus to not recommend adjuvant therapy with sunitinib for patients with high-risk RCC after nephrectomy. Patient summary In two studies, sunitinib was given for 1 yr and compared to no active treatment (placebo) in patients who had their kidney tumour removed and who had a high risk of cancer coming back after surgery. Although one study demonstrated that 1 yr of sunitinib therapy resulted in a 1.2-yr longer time before the disease recurred, the other study did not show a benefit and it has not been shown that patients live longer. Despite having been diagnosed with high-risk disease, many patients remain without recurrence, and the side effects of sunitinib are high. Therefore, the panel members, including patient representatives, do not recommend sunitinib after tumour removal in these patients.
AB - The European Association of Urology Renal Cell Carcinoma (RCC) guidelines panel updated their recommendation on adjuvant therapy in unfavourable, clinically nonmetastatic RCC following the recently reported results of a second randomised controlled phase 3 trial comparing 1-yr sunitinib to placebo for high-risk RCC after nephrectomy (S-TRAC). On the basis of conflicting results from the two available studies, the panel rated the quality of the evidence, the harm-to-benefit ratio, patient preferences, and costs. Finally, the panel, including representatives from a patient advocate group (International Kidney Cancer Coalition) voted and reached a consensus to not recommend adjuvant therapy with sunitinib for patients with high-risk RCC after nephrectomy. Patient summary In two studies, sunitinib was given for 1 yr and compared to no active treatment (placebo) in patients who had their kidney tumour removed and who had a high risk of cancer coming back after surgery. Although one study demonstrated that 1 yr of sunitinib therapy resulted in a 1.2-yr longer time before the disease recurred, the other study did not show a benefit and it has not been shown that patients live longer. Despite having been diagnosed with high-risk disease, many patients remain without recurrence, and the side effects of sunitinib are high. Therefore, the panel members, including patient representatives, do not recommend sunitinib after tumour removal in these patients.
UR - http://www.scopus.com/inward/record.url?scp=85008208816&partnerID=8YFLogxK
U2 - 10.1016/j.eururo.2016.11.034
DO - 10.1016/j.eururo.2016.11.034
M3 - Journal articles
C2 - 27986369
AN - SCOPUS:85008208816
SN - 0302-2838
VL - 71
SP - 719
EP - 722
JO - European Urology
JF - European Urology
IS - 5
ER -