In this interview, Dr Daniel George from the Duke Cancer Institute, Durham, USA discusses results from the SURTIME clinical trial, a randomised study comparing immediate nephrectomy versus 3 months of sunitinib treatment before nephrectomy (neoadjuvant treatment) in people with metastatic kidney cancer at diagnosis. About 100 patients were recruited at about 20 centres. Most of these patients had the bulk of their disease in their primary tumour, and so had a relatively small amount of spread of the cancer.
Most of the patients were able to have surgery, either immediately or following 3 months of sunitinib. The average time to progression of the cancer was about 42 weeks for both treatment groups, so neoadjuvant sunitinib did not affect progression-free survival (PFS). However, for the patients who had immediate surgery followed by sunitinib, median survival was about 15 months. Patients who had 3 months of sunitinib followed by surgery, and then followed by more sunitinib had a median overall survival of 32 months, more than doubling the overall survival for this population starting with sunitinib, doing surgery, and then going back to sunitinib.