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Results from the phase 3 CARMENA study, published in the journal JAMA Oncology, found that pretreatment of renal cell carcinoma (RCC) patients with sunitinib followed by deferred cytoreductive nephrectomy did not improve 28-week progression-free survival rates compared with immediate nephrectomy followed by sunitinib in these patients.
However, patients who received sunitinib followed by deferred cytoreductive nephrectomy showed improved overall survival compared with patients who received immediate nephrectomy followed by sunitinib.
Pretreatment with sunitinib may help doctors identify which patients are resistance to systemic therapy before going ahead with a nephrectomy.
However, the study had several limitations; two European countries were prevented from taking part due to regulatory restrictions, and the study recruited less than a quarter of the patients needed to sufficiently prove the study aims. Results should be interpreted with caution, although the study still provides meaningful data.