Do you see a role for adjuvant sunitinib after resected RCC?
Recent evidence has been mixed, with no DFS or OS benefit in 1 trial (ASSURE, Haas et al, Lancet 2016) and DFS benefit in another (S-TRAC, Ravaud et al, NEJM 2016) but OS was not yet evaluable.
Answer from: Medical Oncologist at Academic Institution
The role of VEGF-R inhibitors as adjuvant therapy in RCC is an evolving field. As you point out, ASSURE was negative but S-TRAC was positive. Each study has to be interpreted on it own while also trying to reconcile the different results. S-TRAC was different in that it was clear cell only, a higher...
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Answer from: Medical Oncologist at Academic Institution
Sunitinib was recently FDA approved based on STRAC data published by Ravaud et al, NEJM 2016 showing an improvement in PFS from 6.8 years vs 5.6 years for those treated with a year of traditional dosing sunitinib following radical nephrectomy for high risk clear cell RCC (T2 G3/4 or T3+ or nodal met...
Answer from: Medical Oncologist at Academic Institution
Additional adjuvant trials will help to sort out the role of adjuvant VEGF-TKI therapy in RCC. Data is pending in 3 other large adjuvant trials which will hopefully provide insight into dose, drug, duration, and patient populations. As adjuvant therapy is not currently FDA approved, these ...