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Immediate Surgery or Surgery After Sunitinib Malate in Treating Patients With Metastatic Kidney Cancer

Phase 3
Conditions
Kidney Cancer
Registration Number
NCT01099423
Lead Sponsor
European Organisation for Research and Treatment of Cancer - EORTC
Brief Summary

RATIONALE: Sunitinib malate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Giving sunitinib malate before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed. Giving sunitinib malate after surgery may kill any tumor cells that remain after surgery. It is not yet known whether undergoing immediate surgery or surgery after sunitinib malate is more effective in treating patients with metastatic kidney cancer.

PURPOSE: This randomized phase III trial is studying immediate surgery to see how well it works compared with surgery after sunitinib malate in treating patients with metastatic kidney cancer.

Detailed Description

OBJECTIVES:

* To determine if immediate versus deferred nephrectomy has an effect on disease control in patients with resectable, synchronous, metastatic renal cell carcinoma treated with sunitinib malate.

* To identify potential response criteria based on histopathology and molecular research on tumor tissue.

OUTLINE: This is a multicenter study. Patients are stratified according to WHO performance status (0 vs 1), number of metastatic sites (1 vs 2 or more), and institution. Patients are randomized to 1 of 2 treatment arms.

* Arm I (immediate nephrectomy): Patients undergo cytoreductive nephrectomy. Beginning 4 weeks after surgery, patients receive oral sunitinib malate once daily on days 1-28. Treatment with sunitinib malate repeats every 6 weeks for 4 courses in the absence of disease progression or unacceptable toxicity.

* Arm II (deferred nephrectomy): Patients receive oral sunitinib malate once daily on days 1-28. Treatment repeats every 6 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. About 1 day after completion of sunitinib malate, patients undergo cytoreductive nephrectomy. Patients then receive oral sunitinib malate once daily on days 1-28. Treatment repeats every 6 weeks for 2 courses in the absence of disease progression or unacceptable toxicity.

Some patients undergo tumor tissue collection at baseline and at time of surgery to assess possible differences in gene expression. Patients also undergo blood sample collection periodically to evaluate the potential impact of serum proteins on the clinical outcome. Samples are then stored for future studies.

After completion of study treatment, patients are followed periodically.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
99
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Primary Outcome Measures
NameTimeMethod
Overall progression-free survival
Secondary Outcome Measures
NameTimeMethod
Overall survival
Effect of nephrectomy on early progression in both arms
Morbidity
Overall response to treatment in the deferred nephrectomy arm including the proportion of patients who become unresectable

Trial Locations

Locations (29)

Onze Lieve Vrouw Ziekenhuis

🇧🇪

Aalst, Belgium

Cliniques Universitaires St. Luc

🇧🇪

Brussels, Belgium

Hôpitaux Universitaires Bordet-Erasme - Institut Jules Bordet

🇧🇪

Brussels, Belgium

Universitair Ziekenhuis Gent

🇧🇪

Gent, Belgium

Virga Jesse Hospital

🇧🇪

Hasselt, Belgium

AZ Groeninghe - Campus Loofstraat

🇧🇪

Kortrijk, Belgium

AZ Damiaan - Campus Sint-Jozef

🇧🇪

Oostende, Belgium

Queen Elizabeth II Health Sciences Centre

🇨🇦

Halifax, Nova Scotia, Canada

CHUM - Pavillon Saint-Luc

🇨🇦

Montreal,, Quebec, Canada

Montreal General Hospital

🇨🇦

Montreal, Canada

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Onze Lieve Vrouw Ziekenhuis
🇧🇪Aalst, Belgium

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