More than 57,000 Americans face a diagnosis of kidney cancer each year, but now patients with soon have another treatment option. A pilot study at UNC Lineberger Comprehensive Cancer Center found that therapy before surgery with the drug Sorafenib can reduce the size of large tumors and could be safely administered without adding significantly to the risks of surgery. Their results are published on-line in the Journal of Clinical Oncology.
Kimryn Rathmell, MD, PhD, a UNC Lineberger physician-scientist, is the study's principal investigator. “We found that primary kidney tumors responded to this therapy, shrinking up to 40 percent prior to surgery. What this means for kidney cancer patients is that their surgery may be less extensive and, we hope, can provide a better outcome,” she says.
At present, removal of the primary tumor (often with the kidney as well) is the standard treatment for patients with kidney cancer, whether the disease is localized to the kidney or has spread to distant sites. This broad spectrum includes patients with very large tumors that may not be ideal for surgical removal as well as patients who may benefit from early systemic interventions, but who would also benefit from removing the kidney later.
This study addressed the question of whether systemic therapy, and in particular, therapy that targets the process by which tumors seek and find new blood vessels to fuel their growth, can benefit patients before they undergo surgery to remove tumors.
Patients in the study took two daily oral doses of the drug for between four to eight weeks prior to surgery. Nexavar, manufactured by Bayer, is a targeted drug used to treat advanced kidney cancer and a type of liver cancer. Two previous studies had been conducted using similar targeted therapy drugs, Sutent and Avastin, but Rathmell's study is the largest to evaluate the use of Nexavar alone, and the first to explore the possibility that pre-operative treatment might benefit patients who do not have metastatic disease.