Published Online:3:34 PM, Fri June 22, 2018
Charles G. Drake, MD, PhD, director of Genitourinary Oncology at New York Presbyterian/Columbia University Medical Center, discusses his thoughts on whether sunitinib (Sutent) would be more successful as a treatment for patients with renal cell carcinoma if used in the neoadjuvant setting.Sunitinib has been the standard of care in the frontline setting of kidney cancer, but it has increasingly become less common. For patients with intermediate- and high-risk disease, many physicians have been using combination immunotherapy with anti-PD-1 and anti-CTLA-4, Drake explains.Preclinical and clinical data has also supported the idea of immunotherapy treatment before surgery. Drake says, a recent report in the New England Journal of Medicine showed neoadjuvant immunotherapy was more efficacious in lung cancer before surgery than after surgery. This has not been suggested yet for kidney cancer, but an ECOG trial is currently investigating nivolumab (Opdivo) monotherapy in the neoadjuvant setting.