Cytoreductive Nephrectomy in the Tyrosine Kinase Inhibitor Era: A Question That May Never Be Answered

Despite great interest, two randomised controlled trials (RCTs) of cytoreductive nephrectomy in the tyrosine kinase inhibitor setting in metastatic renal cell carcinoma have either closed early (SURTIME) or are recruiting very slowly (CARMENA) after 7 yr. Challenges in RCT delivery in uro-oncologic surgery are many. Multiple steps are needed to ensure strong recruitment to trials addressing important urologic cancer questions. Feasibility/pilot studies are key stepping stones towards successful delivery of surgical RCTs.

European urology. 2016 Nov 01 [Epub ahead of print]

Grant D Stewart, Michael Aitchison, Axel Bex, James Larkin, Claire Lawless, Arnaud Méjean, Paul Nathan, Grenville Oades, Jean-Jacques Patard, James Paul, Alain Ravaud, Bernard Escudier, Renal Cross Channel Group

Academic Urology Group, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK. Electronic address: ., Royal Free Hospital, London, UK., Netherlands Cancer Institute, Amsterdam, Netherlands., Royal Marsden Hospital, London, UK., CRUK Clinical Trials Unit, The Beatson West of Scotland Cancer Centre, Glasgow, UK., Université Paris Descartes, Paris, France., Mount Vernon Hospital, Northwood, UK., Queen Elizabeth University Hospital, Glasgow, UK., Hôpital Bicetre, Paris, France., CHU Bordeaux, Bordeaux, France., Gustave Roussy Institute, Paris, France.