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.

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Daniel A. Barocas, MD, MPH, FACS, discusses adjuvant TKI therapy in patients with renal cell carcinoma at high risk of recurrence following cytoreductive nephrectomy.

Dr. Barocas on Adjuvant Sunitinib in Renal Cell Carcinoma

Daniel A. Barocas, MD, MPH, FACS, an associate professor in the Department of Urology at Vanderbilt University Medical Center, discusses the Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) trial in localized prostate cancer.

Barocas led a study in which investigators followed men with prostate cancer from diagnosis on. Patients were given self-reported questionnaires regarding adverse events (AEs). Taken collectively, investigators concluded that each treatment has a unique AE profile. For example, erectile dysfunction and urinary leakage are more likely to result from surgery. Erectile dysfunction is also a concern with radiation. Though, it appears to be a gradual decline with radiation compared with surgery, says Barocas.

At 5 years, many of the resulting AEs taper off, adds Barocas. Though, the risk of urinary incontinence is still higher in patients who undergo surgery versus those who don’t.

Daniel A. Barocas, MD, MPH, FACS

Articles

Dr. Barocas on Adjuvant Sunitinib in Renal Cell Carcinoma

Dr. Barocas on the CEASAR Trial in Localized Prostate Cancer