Kidney cancer treatment has evolved — a new recommendation, based on international research, was presented to the American Society of Clinical Oncology (ASCO).
This recommendation emphasizes the need to select the most appropriate treatment method for patients. with advanced kidney cancer, rather than defaulting to surgical intervention.
At Karazanashvili Roboric Center , this non-surgical approach has already been implemented for some time.
Here is an overview of the international study:
Chicago – A less painful, minimally invasive practice has been developed for treating advanced kidney cancer. According to phase III clinical trial data, patients with kidney cancer may no longer require surgical removal of the affected kidney.
“Cytoreductive nephrectomy is no longer considered the standard of care for metastatic renal carcinoma,”
says the study’s lead author, Dr. Arnaud Mejean, MD, PhD, from Georges Pompidou European Hospital, Paris Descartes University.
Patients can now undergo systemic therapy alone — specifically, targeted therapy with sunitinib (Sutent, Pfizer).
This is supported by the results of the international CARMENA trial, which evaluated the effectiveness of nephrectomy.
The randomized study of 450 patients with low and intermediate risk demonstrated that patients treated with sunitinib alone had survival rates that were not inferior to those who underwent surgery followed by sunitinib (18.4 months vs. 13.9 months).
The study results were presented at the 2018 ASCO Annual Meeting and published in the New England Journal of Medicine (NEJM).
“This study has turned the current paradigm of kidney cancer treatment upside down,” stated Dr. Monty Pal, MD, from City of Hope Cancer Center, during a press conference held in Los Angeles dedicated to the findings.
He explained that while targeted treatments like sunitinib have significantly improved survival for these patients over the past decade, oncologists had continued to favor surgery to remove the kidney — believing it to be the better approach.
However, this perception and practice were mostly based on retrospective national registry data, which “lack high confirmation strength,” Pal noted.
Some experts have pointed out that the new results require deeper examination.
Not everyone agrees.
In an editorial accompanying the study in NEJM, Drs. Robert Motzer and Paul Russo from Memorial Sloan Kettering Cancer Center in New York remarked:
“It’s not surprising these results emerged, as the study mostly involved low-risk patients.”
Indeed, 43% of enrolled patients were classified as low-risk.