FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W1974850795> ?p ?o ?g. }

• W1974850795 endingPage "456" @default.
• W1974850795 startingPage "455" @default.
• W1974850795 abstract "There is currently a paucity of high-level evidence regarding the role of cytoreductive nephrectomy in the era of targeted therapy. Patients diagnosed with metastatic renal carcinoma are confronted with difficult treatment decisions regarding the optimal treatment strategy and the timing of surgery in relation to targeted therapy. Level 1 evidence from two randomized trials has demonstrated improved overall survival with cytoreductive nephrectomy in the immunotherapy era [1–3]. Current clinical guidelines recommend cytoreductive nephrectomy followed by systemic therapy for patients presenting with metastatic renal carcinoma in which the primary tumor is surgically resectable and where the treatment is individualized based on symptoms and extent of metastatic disease [4]. In this issue of the Platinum Journal, Powles et al report a pooled analysis of two single-arm, phase 2 prospective trials and evaluate the efficacy and outcomes of sunitinib prior to cytoreductive nephrectomy [5]. Although the authors previously reported safety with neoadjuvant sunitinib prior to cytoreductive nephrectomy [6], this investigation describes the outcomes for the 66 patients who received two or three cycles of sunitinib prior to surgery. Two principal findings from this study help inform the debate regarding the optimal treatment strategy of targeted therapy and cytoreductive nephrectomy. First, patients who are in the Memorial Sloan-Kettering Cancer Center (MSKCC) intermediate risk group can achieve a lasting response with a median overall survival >2 yr compared with patients harboring poor-risk disease, for whom a markedly shorter median overall survival of 9 mo was observed. These results suggest that patient selection, particularly by MSKCC risk stratification, is paramount in identifying those patients who are most likely to benefit from targeted therapy prior to cytoreductive nephrectomy. Second, the authors also observed that interruptions of sunitinib in preparation for surgery were associated with a high rate of disease progression. Although the study attempted to apply a rigorous protocol to minimize the time off of targeted therapy by reinitiating sunitinib within 2–3 wk following cytoreductive nephrectomy, there was considerable variation in the amount of time off of therapy following surgery. Consequently, 36% of the patients had disease progression by RECIST criteria and eight patients had new metastatic sites during the perioperative convalescence interval without sunitinib. Thus patients treated with sunitinib who plan to stop treatment for surgical intervention should be informed about the risk of disease progression. Although the authors acknowledge the need to validate their findings with a randomized trial, the results of this study suggest that cytoreductive nephrectomy may have limited efficacy in patients who experience disease progression following initiation of sunitinib or in patients with poor MSKCC risk. To date, no level 1 evidence has evaluated the efficacy of cytoreductive nephrectomy and targeted therapy, whether neoadjuvant or adjuvant, in patients presenting with metastatic renal carcinoma. Proponents of cytoreductive nephrectomy have extrapolated the results from randomized trials of sunitinib and immunotherapy in patients who underwent previous nephrectomy and then developed metastatic disease and from the two randomized trials that set the current treatment paradigm of cytoreductive nephrectomy [1–3,7,8]. Currently, an ongoing phase 3 trial is recruiting patients presenting with metastatic renal carcinoma to be randomized to immediate cytoreductive nephrectomy followed by sunitinib or three cycles of sunitinib (4 wk of sunitinib and then 2 wk off) followed by" @default.
• W1974850795 created "2016-06-24" @default.
• W1974850795 creator A5053084361 @default.
• W1974850795 creator A5067883322 @default.
• W1974850795 date "2011-09-01" @default.
• W1974850795 modified "2023-09-25" @default.
• W1974850795 title "Sunitinib Prior to Planned Cytoreductive Nephrectomy: Is This the New Litmus Test for Metastatic Renal Cell Carcinoma?" @default.
• W1974850795 cites W2040259869 @default.
• W1974850795 cites W2099088585 @default.
• W1974850795 cites W2105937199 @default.
• W1974850795 cites W2116661424 @default.
• W1974850795 cites W2140659843 @default.
• W1974850795 cites W2145969161 @default.
• W1974850795 cites W2149456801 @default.
• W1974850795 cites W2399468611 @default.
• W1974850795 cites W2414641360 @default.
• W1974850795 doi "https://doi.org/10.1016/j.eururo.2011.05.056" @default.
• W1974850795 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/21680083" @default.
• W1974850795 hasPublicationYear "2011" @default.
• W1974850795 type Work @default.
• W1974850795 sameAs 1974850795 @default.
• W1974850795 citedByCount "2" @default.
• W1974850795 countsByYear W19748507952013 @default.
• W1974850795 crossrefType "journal-article" @default.
• W1974850795 hasAuthorship W1974850795A5053084361 @default.
• W1974850795 hasAuthorship W1974850795A5067883322 @default.
• W1974850795 hasConcept C126322002 @default.
• W1974850795 hasConcept C126894567 @default.
• W1974850795 hasConcept C143998085 @default.
• W1974850795 hasConcept C147789679 @default.
• W1974850795 hasConcept C157329479 @default.
• W1974850795 hasConcept C185592680 @default.
• W1974850795 hasConcept C2777472916 @default.
• W1974850795 hasConcept C2779490328 @default.
• W1974850795 hasConcept C2780091579 @default.
• W1974850795 hasConcept C2780227381 @default.
• W1974850795 hasConcept C71924100 @default.
• W1974850795 hasConceptScore W1974850795C126322002 @default.
• W1974850795 hasConceptScore W1974850795C126894567 @default.
• W1974850795 hasConceptScore W1974850795C143998085 @default.
• W1974850795 hasConceptScore W1974850795C147789679 @default.
• W1974850795 hasConceptScore W1974850795C157329479 @default.
• W1974850795 hasConceptScore W1974850795C185592680 @default.
• W1974850795 hasConceptScore W1974850795C2777472916 @default.
• W1974850795 hasConceptScore W1974850795C2779490328 @default.
• W1974850795 hasConceptScore W1974850795C2780091579 @default.
• W1974850795 hasConceptScore W1974850795C2780227381 @default.
• W1974850795 hasConceptScore W1974850795C71924100 @default.
• W1974850795 hasIssue "3" @default.
• W1974850795 hasLocation W19748507951 @default.
• W1974850795 hasLocation W19748507952 @default.
• W1974850795 hasOpenAccess W1974850795 @default.
• W1974850795 hasPrimaryLocation W19748507951 @default.
• W1974850795 hasRelatedWork W149429698 @default.
• W1974850795 hasRelatedWork W2039415179 @default.
• W1974850795 hasRelatedWork W2070689892 @default.
• W1974850795 hasRelatedWork W2070756340 @default.
• W1974850795 hasRelatedWork W2096517981 @default.
• W1974850795 hasRelatedWork W2166689662 @default.
• W1974850795 hasRelatedWork W2922087791 @default.
• W1974850795 hasRelatedWork W2965179065 @default.
• W1974850795 hasRelatedWork W3033178514 @default.
• W1974850795 hasRelatedWork W3174785964 @default.
• W1974850795 hasVolume "60" @default.
• W1974850795 isParatext "false" @default.
• W1974850795 isRetracted "false" @default.
• W1974850795 magId "1974850795" @default.
• W1974850795 workType "article" @default.