Cancer Treatment Today

At this time, NCCN does not recommend adjuvant treatment for stage III renal cancer. It si nto established by NCCN or per literature. A summer 2016 study in the New England Journal of Medicine showed that among patients with locoregional clear-cell renal-cell carcinoma at high risk for tumor recurrence after nephrectomy, the median duration of disease-free survival was significantly longer in the sunitinib group than in the placebo group, at a cost of a higher rate of toxic events.

However, interim analysis of a randomized phase 3 trial of sunitinib versus sorafenib versus placebo as adjuvant therapy in patients with resected renal cell carcinoma showed no difference in disease-free or overall survival. The investigators concluded that  patients with locally advanced resected renal cell carcinoma should not be given adjuvant treatment.

Alain Ravaud, M.D., Ph.D., Robert J. Motzer, M.D., Hardev S. Pandha, M.D., Ph.D., Daniel J. George, M.D., Allan J. Pantuck, M.D., Anup Patel, M.S., F.R.C.S., Yen-Hwa Chang, M.D., Ph.D., Bernard Escudier, M.D., Frede Donskov, M.D., Ph.D., Ahmed Magheli, M.D., Ph.D., Giacomo Carteni, M.D., Brigitte Laguerre, M.D., Piotr Tomczak, M.D., Jan Breza, M.D., Ph.D., Paola Gerletti, B.Sc.D., Mariajose Lechuga, M.D., Xun Lin, Ph.D., Jean-Francois Martini, Ph.D., Krishnan Ramaswamy, Ph.D, Michelle Casey, Ph.D., Michael Staehler, M.D., Ph.D., and Jean-Jacques Patard, M.D., Ph.D., for the S-TRAC Investigators*Adjuvant Sunitinib in High-Risk Renal-Cell Carcinoma after Nephrectomy. N Engl J Med 2016; 375:2246-2254December 8, 2016

Naomi B. Haas, Judith Manola, Robert G. Uzzo, Michael B. Atkins, George Wilding, Michael Pins, Michael A. S. Jewett, Christopher J. Kane, David Cella, Lynne I. Wagner, Bob Coomes, Christopher G. Wood, Janice P. Dutcher, Keith Flaherty, Robert S. DiPaola;Initial results from ASSURE (E2805): Adjuvant sorafenib or sunitinib for unfavorable renal carcinoma, an ECOG-ACRIN-led, NCTN phase III trial. J Clin Oncol 33, 2015 (suppl 7; abstr 403)