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Updated European Association of Urology Guidelines Regarding Adjuvant Therapy for Renal Cell Carcinoma
A. Bex, L. Albiges, B. Ljungberg, K. Bensalah, S. Dabestani, RH. Giles, F. Hofmann, M. Hora, MA. Kuczyk, TB. Lam, L. Marconi, AS. Merseburger, M. Staehler, A. Volpe, T. Powles,
Jazyk angličtina Země Švýcarsko
Typ dokumentu časopisecké články
- MeSH
- adjuvantní chemoterapie MeSH
- indoly terapeutické užití MeSH
- karcinom z renálních buněk farmakoterapie patologie MeSH
- lidé MeSH
- nádory ledvin farmakoterapie patologie MeSH
- nefrektomie * MeSH
- protinádorové látky terapeutické užití MeSH
- pyrroly terapeutické užití MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- společnosti lékařské MeSH
- urologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
The European Association of Urology Renal Cell Carcinoma (RCC) guidelines panel updated their recommendation on adjuvant therapy in unfavourable, clinically nonmetastatic RCC following the recently reported results of a second randomised controlled phase 3 trial comparing 1-yr sunitinib to placebo for high-risk RCC after nephrectomy (S-TRAC). On the basis of conflicting results from the two available studies, the panel rated the quality of the evidence, the harm-to-benefit ratio, patient preferences, and costs. Finally, the panel, including representatives from a patient advocate group (International Kidney Cancer Coalition) voted and reached a consensus to not recommend adjuvant therapy with sunitinib for patients with high-risk RCC after nephrectomy. PATIENT SUMMARY: In two studies, sunitinib was given for 1 yr and compared to no active treatment (placebo) in patients who had their kidney tumour removed and who had a high risk of cancer coming back after surgery. Although one study demonstrated that 1 yr of sunitinib therapy resulted in a 1.2-yr longer time before the disease recurred, the other study did not show a benefit and it has not been shown that patients live longer. Despite having been diagnosed with high-risk disease, many patients remain without recurrence, and the side effects of sunitinib are high. Therefore, the panel members, including patient representatives, do not recommend sunitinib after tumour removal in these patients.
Academic Urology Unit University of Aberdeen Aberdeen UK
Department of Cancer Medicine Institut Gustave Roussy Villejuif France
Department of Surgical and Perioperative Sciences Urology and Andrology Umeå University Umeå Sweden
Department of Urology Aberdeen Royal Infirmary Aberdeen UK
Department of Urology and Urologic Oncology Hannover Medical School Hannover Germany
Department of Urology Coimbra University Hospital Coimbra Portugal
Department of Urology Ludwig Maximilians University Munich Germany
Department of Urology Skåne University Hospital Malmö Sweden
Department of Urology Sunderby Hospital Sunderby Sweden
Department of Urology University Hospital Schleswig Holstein Lübeck Germany
Department of Urology University of Rennes Rennes France
Division of Urology Maggiore della Carità Hospital University of Eastern Piedmont Novara Italy
Patient Advocacy International Kidney Cancer Coalition Duivendrecht The Netherlands
The Royal Free NHS Trust and Barts Cancer Institute Queen Mary University of London London UK
University Medical Centre Utrecht Nephrology Department Utrecht The Netherlands
Citace poskytuje Crossref.org
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- $a Bex, Axel $u Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: a.bex@nki.nl.
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- $a The European Association of Urology Renal Cell Carcinoma (RCC) guidelines panel updated their recommendation on adjuvant therapy in unfavourable, clinically nonmetastatic RCC following the recently reported results of a second randomised controlled phase 3 trial comparing 1-yr sunitinib to placebo for high-risk RCC after nephrectomy (S-TRAC). On the basis of conflicting results from the two available studies, the panel rated the quality of the evidence, the harm-to-benefit ratio, patient preferences, and costs. Finally, the panel, including representatives from a patient advocate group (International Kidney Cancer Coalition) voted and reached a consensus to not recommend adjuvant therapy with sunitinib for patients with high-risk RCC after nephrectomy. PATIENT SUMMARY: In two studies, sunitinib was given for 1 yr and compared to no active treatment (placebo) in patients who had their kidney tumour removed and who had a high risk of cancer coming back after surgery. Although one study demonstrated that 1 yr of sunitinib therapy resulted in a 1.2-yr longer time before the disease recurred, the other study did not show a benefit and it has not been shown that patients live longer. Despite having been diagnosed with high-risk disease, many patients remain without recurrence, and the side effects of sunitinib are high. Therefore, the panel members, including patient representatives, do not recommend sunitinib after tumour removal in these patients.
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