Sunitinib Alone or after Nephrectomy in Metastatic Renal-Cell Carcinoma

Méjean, Arnaud; Ravaud, Alain; Thézenas, Simon; Colas, Sandra; Beauval, Jean-Baptiste; Bensalah, Karim; Geoffrois, Lionnel; Thiery-Vuillemin, A.; Cormier, Laurent; Lang, Hervé; Guy, Laurent; Gravis, Gwénaëlle; Rolland, Frédéric; Linassier, Claude; Lechevallier, É.; Beisland, Christian; Aitchison, Michael; Oudard, Stéphane; Patard, Jean‐Jacques; Théodore, C; Chevreau, Christine; Laguerre, Brigitte; Hubert, Jacques; Gross‐Goupil, Marine; Bernhard, Jean-Christophe; Albigès, Laurence; Timsit, Marc‐Olivier; Lebrét, Thierry; Escudier, Bernard

doi:10.1056/nejmoa1803675

Cited by 719 publications

(519 citation statements)

References 19 publications

Supporting

Mentioning

483

Contrasting

Unclassified

Order By: Relevance

“…However, the role of CN and metastasectomy in the area of TT still needs to be defined. Recently, the randomized phase III CARMENA trial showed that sunitinib alone was not inferior to CN followed by sunitinib in patients with mCCRCC who were classified as having intermediate‐risk or poor‐risk disease (HR: 0.89; 95% CI: 0.71 to 1.10; upper boundary of the 95% CI for noninferiority, ≤1.20) . The median OS for patients who received the sunitinib alone was 18.4 months, compared with 13.9 months for those who received CN followed by sunitinib.…”

Section: Discussionmentioning

confidence: 99%

Survival and clinical prognostic factors in metastatic non‐clear cell renal cell carcinoma treated with targeted therapy: A multi‐institutional, retrospective study using the Korean metastatic renal cell carcinoma registry

Kim

Song

et al. 2019

Cancer Medicine

View full text Add to dashboard Cite

Objectives The optimal treatment strategy for metastatic non‐clear cell renal cell carcinoma (mNCCRCC) is still elusive and mainly extrapolated from evidence available for metastatic clear cell renal cell carcinoma. The aim of the study was therefore to investigate the survival outcomes and prognostic factors affecting survival in patients with mNCCRCC treated with targeted therapy. Materials and methods We analyzed a total of 156 patients (8.1%) with mNCCRCC among the total cohort of 1922 patients in the Korean metastatic RCC registry. We used Kaplan‐Meier curve analysis to calculate the survival estimates for first‐line progression‐free survival (PFS), total PFS, and cancer‐specific survival (CSS). We also used the log‐rank test to compare the different groups and multivariate Cox‐proportional hazard regression analyses to evaluate the prognostic factors for survival. Results The mNCCRCC group had significantly inferior survival outcomes in terms of first‐line PFS, total PFS, and CSS (all P < 0.05). We found survival benefits in patients treated with first‐line vascular endothelial growth factor‐tyrosine kinase inhibitors (VEGF‐TKIs, first‐line PFS, and total PFS, all P < 0.05), cytoreductive nephrectomy (CSS, P < 0.0001), metastasectomy (CSS, P = 0.0017), and patients with metachronous metastasis (first‐line PFS, total PFS, and CSS, all P < 0.05). Liver metastasis was the only significant prognostic factor for both first‐line PFS and CSS (all P < 0.05). Conclusions In the current targeted therapy era, survival of mNCCRCC is still inferior in comparison with that of mCCRCC patients. We found survival benefits in patients treated with first‐line VEGF‐TKIs/CN/metastasectomy, and metachronous metastasis patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Survival and clinical prognostic factors in metastatic non‐clear cell renal cell carcinoma treated with targeted therapy: A multi‐institutional, retrospective study using the Korean metastatic renal cell carcinoma registry

Kim

Song

et al. 2019

Cancer Medicine

View full text Add to dashboard Cite

show abstract

“…Metastatic lesions, aside from pathologic staging, may provide the only diagnostic tissue for prognosis and therapy selection in patients who are not candidates for surgery. The latter scenario is likely to prospectively increase the role for (and stakes of) cytologic and/or biopsy sampling in the metastatic setting, given recent findings and trends against cytoreductive nephrectomy . Finally, contemporary National Comprehensive Cancer Network guidelines emphasize the importance of a diagnosis of clear cell RCC versus other RCC entities in management decisions, given the greater efficacy of angiogenesis‐directed tyrosine kinase inhibitor therapies in this subtype.…”

Section: Introductionmentioning

confidence: 99%

New entities, new technologies, new findings: A review of the cytologic features of recently established subtypes of renal cell carcinoma

Robila

Kraft

Smith

2019

Cancer Cytopathology

View full text Add to dashboard Cite

Several new renal tumor types with distinctive pathologic, epidemiologic, and genetic signatures have recently been adopted in the fourth edition of the World Health Organization classification. In succeeding years, the cytologic features of most of these new types have been described, adding to the trend of increasing diagnostic accuracy for most common renal cell carcinoma subtypes and the important diagnostic role of cytologic sampling in the management and personalization of therapy. The current article reviews the cytologic findings from these recently established renal cell carcinoma subtypes. Emphasis is placed on cytologic diagnostic clues, confirmatory ancillary testing, salient differential diagnoses, and challenges that can be encountered in an attempt to render accurate interpretations in small samples.

show abstract

“…The percentage of metastases of RCC at diagnosis has decreased to 14-15% in the recent population-based reports [13,20], which is quite similar to the 12% found in the present cohort. To date, there is no evidence from randomized studies to support the use of CN in the era of targeted therapy [21]. Indeed, the use of nephrectomy in patients with metastatic RCC has declined in many countries to 33-34% [22,23].…”

Section: Discussionmentioning

confidence: 99%

Evolving Clinical Picture of Renal Cell Carcinoma: A Population-Based Study from Helsinki

et al. 2019

View full text Add to dashboard Cite

Background: There is a lack of detailed population-based data for renal cell carcinoma (RCC). Objectives: The study aimed to examine the contemporary changes in the clinical picture and treatment of RCC. Methods: A total of 1,719 consecutive patients living in the Helsinki metropolitan area with a solid or cystic renal mass (Bosniak 3–4) ≥10 mm were identified. Data from medical records was evaluated for clinical characteristics and treatments in the periods I (2006–2008), II (2009–2011), III (2012–2014), and IV (2015–2016). Results: The proportions of patients with comorbidities (Charlson index ≥2) and frailty (Eastern Co-operative Oncology Group classification ≥2) increased significantly during the study period. The percentage of clinical stage I patients, cystic tumors and use of needle biopsies increased significantly. Use of observation increased from 9% (I) to 32% (IV; p < 0.001). First-line oncological treatments within 6 months were given to 47% of 262 patients with metastases and cytoreductive nephrectomy (CN) was delivered to 54% of those patients. Conclusions: The size of renal tumors continued to decrease, while the percentage of patients with significant comorbidity or frailty increased. Active surveillance emerged as the initial strategy. Tyrosine kinase inhibitors with CN remained the primary option in patients with metastatic RCC.

show abstract

Sunitinib Alone or after Nephrectomy in Metastatic Renal-Cell Carcinoma

Cited by 719 publications

References 19 publications

Survival and clinical prognostic factors in metastatic non‐clear cell renal cell carcinoma treated with targeted therapy: A multi‐institutional, retrospective study using the Korean metastatic renal cell carcinoma registry

Survival and clinical prognostic factors in metastatic non‐clear cell renal cell carcinoma treated with targeted therapy: A multi‐institutional, retrospective study using the Korean metastatic renal cell carcinoma registry

New entities, new technologies, new findings: A review of the cytologic features of recently established subtypes of renal cell carcinoma

Evolving Clinical Picture of Renal Cell Carcinoma: A Population-Based Study from Helsinki

Contact Info

Product

Resources

About