The two recent prospective randomized trials CARMENA and SURTIME have changed the therapy paradigm of metastatic renal cell carcinoma. The CARMENA trial was conducted to investigate whether cytoreductive nephrectomy (CN) is required in the targeted therapy area, whereas SURTIME studied whether deferred CN in combination with sunitinib can be used to identify patients with inherent targeted therapy resistance. In the current review, we provide a comprehensive discussion of two randomized studies and the current evidence with up-do-date algorithms for treating primary metastatic clear-cell renal cell carcinoma in the era of targeted therapy and immune-checkpoint inhibition.
Therapeutic advances in medical oncology. 2019 Sep 27*** epublish ***
Teele Kuusk, Bernadett Szabados, Wing Kin Liu, Thomas Powles, Axel Bex
Royal Free Hospital, Department of Urology, Renal Cancer Unit, London, UK., Barts Experimental Cancer Medicine Centre, Barts Cancer Institute, Queen Mary University of London, London, UK., Royal Free Hospital, Department of Medical Oncology, London, UK., Royal Free Hospital, Department of Urology, Renal Cancer Unit, University College London, Division of Surgical and Interventional Sciences, London, UK.