Ongoing studies in the neoadjuvant setting for RCC
David M. Nanus, M.D., talked to OncLive about ongoing studies in the neoadjuvant setting for patients with renal cell carcinoma (RCC). In the neoadjuvant setting, there has been many studies predominantly looking at anti-VEGF therapies, explains Nanus. These studies are being done to determine if tumor shrinkage and resectability are improved, will outcomes also improve, or are there postoperative complications? If you look at these studies, the progression-free survival is the same, states Nanus. The clear role is attempting to prevent the need for dialysis by leaving some kidney behind and shrinking the cancer preoperatively. Additional OncLive coverage here.
Dr Nanus also spoke to Targeted Oncology about determining a role for neoadjuvant/adjuvant therapy in RCC.
Nanus explained that rapid initiation of systemic therapy prior to surgery could decrease cancer-related mortality and eliminate these risks in patients who would not benefit from nephrectomy. However, “it may add to the morbidity or mortality of surgery if you give the drug; you may ‘decondition’ the patient and [then] they can’t get systemic therapy. And it hasn’t been proven that it improves survival, so why should we do it?”