AUA 2019: Patient Perspectives on Cytoreductive Nephrectomy after CARMENA

Chicago, IL ( Dena Battle, President of KCCure, and her colleagues wanted to record and present the patient’s views after the CARMENA  study. The CARMENA trial created a controversy around the topic of Cytoreductive Nephrectomy (CN) and systemic tyrosine kinase inhibitor (TKI) therapy. A point was made that overall survival benefits are not always the most important factor for a patient.

The survey was conducted on patients diagnosed with metastatic renal cell carcinoma (mRCC) patients. The survey that was sent out via SurveyMonkey, which included nine questions: three on demographic, five on the history of the disease, and one on the views of the CARMENA trial. The main target of their survey was to ask patients if they continued to want a CN despite there being no added overall survival benefit when starting systemic therapy.

The majority of the respondents still wanted a CN (75%). Of the patients on systemic therapy with primary mRCC, 85% would still like to have surgery. The majority of the patients who answered still wanted to have their primary tumor resected. Battle highlights that overall survival benefit should not be considered as the most important factor in patient care. There may be a need for a practice change in this factor, as patients would view the value of surgery different than that of physicians.

In the question section, one doctor notes that physicians can do all the survival analytics you could ever want, but when he manages patients, he would be unhappy if patients were not at their best. This would inevitably lead him to perform surgery on the patient, despite there being no added benefit to survival. The moderator also noted a possible limitation of this study is that this survey was sent out to patients after their systemic therapy. This meant that patients who were failing systemic therapy would most likely have said that CN was a great idea.

Presented by: Dena Battle, President, Kidney Cancer Research Alliance KCCure
Authors: Axel Bex, Daniel J. George, Michael D. Staehler
Affiliation: Netherlands Cancer Institute, Duke Cancer Institute, and University of Munich 

Written by: Joshua Tran, (Department of Urology, University of California-Irvine) at the American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois

Further Related Content: 
Watch: Patient Perspectives on Cytoreductive Nephrectomy after the CARMENA Trial - Dena Battle
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