Dr. Van Veldhuizen Reflects on the CARMENA Trial in RCC

Peter J. Van Veldhuizen, MD, hematologist/oncologist, Sarah Cannon Research Institute, discusses the impact of the CARMENA trial results in renal cell carcinoma (RCC).

Findings from the phase III CARMENA trial showed that sunitinib (Sutent) alone was noninferior for median overall survival compared with sunitinib plus cytoreductive nephrectomy in patients with synchronous metastatic RCC. Smart patient selection is of the utmost importance, Van Veldhuizen says. CARMENA showed that patients who have more extensive metastatic disease or a smaller primary lesion are less likely to benefit from cytoreductive nephrectomy.

Van Veldhuizen says that he hopes these results do not shift the standard of care too far away from debulking nephrectomy. There is still a clear benefit in utilizing surgery in select patients, such as those with a primary lesion or small-volume systemic disease, as well as patients with a better performance status.

In addition, there is also question of the role of cytoreductive nephrectomy in the age of immunotherapy, Van Veldhuizen adds.