The following is a summary of “Multicenter randomized trial of deferred cytoreductive nephrectomy in synchronous metastatic renal cell carcinoma receiving checkpoint inhibitors: the NORDIC-SUN-Trial,” published in the February 2024 issue of Oncology by Iisager et al.
The investigation into the role of cytoreductive nephrectomy in synchronous metastatic renal cell carcinoma (mRCC) patients undergoing various treatment modalities has yielded crucial insights. Previous randomized controlled trials have underscored the shifting treatment landscape, emphasizing that upfront nephrectomy is no longer warranted when systemic therapy is indicated. With the advent of checkpoint immunotherapy agents, there has been a notable transition from targeted therapies to immunotherapy-based first-line treatments in patients with primary metastatic disease. Consequently, the efficacy of deferred cytoreductive nephrectomy warrants validation within this immunotherapy context, highlighting the necessity for personalized treatment strategies to mitigate unnecessary overtreatment.
To address these critical questions, researchers have initiated a rigorous randomized controlled trial comparing deferred cytoreductive nephrectomy with no surgery in mRCC patients undergoing checkpoint immunotherapy. This trial is augmented by a comprehensive translational research program integrating specimen sampling for biomarker analysis. Through this multidimensional approach, the study group aims to evaluate the impact of deferred cytoreductive nephrectomy on overall survival and delineate relevant biomarkers that hold promise for personalized renal cancer management. By elucidating the optimal treatment strategies and identifying predictive biomarkers, this trial endeavors to advance precision oncology and enhance patient outcomes in the management of synchronous mRCC.
Source: bmccancer.biomedcentral.com/articles/10.1186/s12885-024-11987-3