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.
Academic Urology Group, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK. Electronic address: gds35@cam.ac.uk.
Grant D
GD
Stewart
Royal Free Hospital, London, UK.
Michael
M
Aitchison
Netherlands Cancer Institute, Amsterdam, Netherlands.
Axel
A
Bex
Royal Marsden Hospital, London, UK.
James
J
Larkin
CRUK Clinical Trials Unit, The Beatson West of Scotland Cancer Centre, Glasgow, UK.
Claire
C
Lawless
Université Paris Descartes, Paris, France.
Arnaud
A
Méjean
Mount Vernon Hospital, Northwood, UK.
Paul
P
Nathan
Queen Elizabeth University Hospital, Glasgow, UK.
Grenville
G
Oades
Hôpital Bicetre, Paris, France.
Jean-Jacques
JJ
Patard
CRUK Clinical Trials Unit, The Beatson West of Scotland Cancer Centre, Glasgow, UK.
James
J
Paul
CHU Bordeaux, Bordeaux, France.
Alain
A
Ravaud
Gustave Roussy Institute, Paris, France.
Bernard
B
Escudier
D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000201:enzymology / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D065426:Cytoreduction Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D007680:Kidney Neoplasms / Q000201:enzymology / Q000473:pathology / Q000628:therapy*; D058990:Molecular Targeted Therapy; D009392:Nephrectomy / Q000009:adverse effects; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors