Dr. George on the Use of Adjuvant Sunitinib in RCC

Daniel J. George, MD, professor of medicine and surgery, member, Duke Cancer Institute, discusses the use of adjuvant sunitinib (Sutent) in the treatment of patients with renal cell carcinoma (RCC).

The field of RCC is rapidly changing, explains George, as evidenced by the FDA approval of nivolumab (Opdivo) and ipilimumab (Yervoy), and expanded indication for cabozantinib (Cabometyx) in the frontline. However, there have not been as many developments for patients with stage III disease.

Several trials have investigated the use of adjuvant TKI therapy, but failed to report positive findings, until recently. Findings from the S-TRAC trial presented at the 2018 ESMO Congress showed that 50 mg of sunitinib given on a 4 weeks on/2 weeks off schedule for 1 year resulted in an improved disease-free survival in patients with high-risk RCC. Specifically, there was a 24% reduction in the risk of disease recurrence and an 8% absolute improvement in recurrence-free survival at 5 years. Although these results led to sunitinib’s FDA approval for this indication in November 2017, George says that its use has been hindered by the negative studies to date.