People who received sunitinib treatment alone survived at least as long as those who received the drug after surgical removal of their kidney, according to a randomized study of 450 patients with synchronous metastatic renal cell carcinoma.
A team led by Dr. Arnaud Mejean of Hopital Europeen Georges-Pompidou in Paris found that conventional surgery and sunitinib produced a median overall survival time of 13.9 months while skipping surgery extended that time to 18.4 months, a non-significant difference, and eliminated the risks of infection, blood loss and other surgical complications.
Among the 40,000 to 50,000 people worldwide in whom renal-cell carcinoma is diagnosed, it has typically metastasized in 20% of patients.
The better outcome with sunitinib alone may be due to the fact that kidney removal usually delays sunitinib therapy by four to six weeks so the patient can recover, making it harder for the drug to do its work, the researchers speculate.
There were non-significant increases in the time to disease progression and median survival for patients with both an intermediate and a poor prognosis.
Patients with only one metastasis were not included in the trial, known as CARMENA.
The findings were presented June 3 at the American Society of Clinical Oncology annual meeting in Chicago.
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