Neoadjuvant Sunitinib Linked to Improved Outcomes in RCC with Thrombus

Neoadjuvant sunitinib was linked to primary tumor and thrombus shrinkage, reduced blood loss during surgery, as well as improved cancer-specific survival.
Neoadjuvant sunitinib was linked to primary tumor and thrombus shrinkage, reduced blood loss during surgery, as well as improved cancer-specific survival.

NEW ORLEANS -- Neoadjuvant sunitinib might aid shrinkage of the primary tumor and thrombus in patients with metastatic or advanced renal cell carcinoma (RCC), according to research findings presented at the 2015 American Urological Association meeting.

Investigators led by Hak Lee, MD, of the VA San Diego Healthcare System, compared outcomes for 53 RCC patients with tumor thrombus (and other indications) from two centers treated with (19) and without (34) neoadjuvant sunitinib prior to surgery. Both groups initially had similar levels of tumor thrombus.

Using RECIST criteria, the researchers determined that neoadjuvant sunitinib treatment was associated with reduction in the size of the primary tumor and thrombus, reduced blood loss, as well as better cancer-specific survival. In the neoadjuvant sunitinib group, the primary tumor shrank from 8.1 cm to 6.8 cm, on median; thrombus size also decreased by a median 1.3 cm. Slightly more than half of the neoadjuvant group maintained thrombus level and 42% experienced a decrease. Median cancer-specific survival was 72 versus 38 months in the neoadjuvant versus no neoadjuvant groups.

While the results from their retrospective research are encouraging, the investigators recommend further studies to determine the utility of neoadjuvant sunitinib. 

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