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A study published in The Lancet last week reported that adjuvant treatment (treatment following surgery) with the VEGF receptor tyrosine kinase inhibitors sorafenib or sunitinib showed no survival benefit relative to placebo in a definitive phase 3 study. Furthermore, substantial treatment discontinuation occurred because of excessive toxicity, despite dose reductions. These results provide a strong rationale against the use of these drugs after surgery for high-risk kidney cancer that has not spread, and suggest that the biology of cancer recurrence might be independent of angiogenesis.