Daniel A. Barocas, MD, MPH, FACS, discusses adjuvant TKI therapy in patients with renal cell carcinoma at high risk of recurrence following cytoreductive nephrectomy.
Daniel A. Barocas, MD, MPH, FACS, an associate professor in the Department of Urology at Vanderbilt University Medical Center, discusses adjuvant TKI therapy in patients with renal cell carcinoma (RCC) at high risk of recurrence following cytoreductive nephrectomy.
The most compelling data in favor of adjuvant TKI therapy in RCC comes from the phase III S-TRAC study, which showed a disease-free survival advantage for sunitinib (Sutent) compared with placebo; however, those results are competing with other studies that show no advantage for sunitinib, explains Barocas.
The S-TRAC study showed some adverse events (AEs) in the sunitinib arm compared with the placebo arm. Key AEs occurred a median of 1 month after the start of treatment and resolved within a median 3.5 weeks. Data showed that 40.6% of grade 1/2 AEs led to discontinuation and 87.2% of AEs were resolved or were resolving by 28 days after the last treatment. Barocas suggests using adjuvant sunitinib for patients who are motivated to prevent disease recurrence.