– Niels Fristrup, MD, PhD, Principal Investigator of the NORDIC SUN trial.
Primary tumor removal by cytoreductive nephrectomy (CN) in synchronous metastatic renal cell carcinoma patients has been investigated in the context of various treatment regimens.
In the era of targeted tyrosine kinase inhibitor therapy two randomized trials, CARMENA and SURTIME, have questioned the role and timing of CN in synchronous mRCC patients with results pointing towards an improved benefit upon a deferred approach; except for IMDC poor risk patients. The deferred CN approach ensures systemic therapy for all patients, avoids systemic treatment delay, and spares surgery in patients with progressive tumors.
During recent years, standard treatment has evolved to IO-IO or IO-TKI combinations, and in NORDIC SUN (NCT03977571) we test the effect of deferred CN in mRCC patients receiving contemporary mRCC treatment. Concurrently, the PROBE trial (NCT04510597) is recruiting in the US, also trying to answer this clinical question, thereby underlining its importance in the management of primary metastatic RCC.
NORDIC SUN furthermore integrates a comprehensive translational research program with tissue, blood, and microbiome sampling for biomarker analysis, see Figure 1.
Written by: Laura Iisager,1 Johanne Ahrenfeldt, PhD,1 Frede Donskov, MD, PhD,2,3 Börje Ljungberg,4 Axel Bex,5 Lars Lund, MD, DMSci,6 Iben Lyskjær, PhD,1 Niels Fristrup, MD, PhD,7
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark.
- Department of Oncology, Southern Denmark University Hospital, Esbjerg, Denmark.
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
- Specialist Centre for Kidney Cancer, Royal Free Hospital London, London, England.
- Department of Urology, Odense University Hospital, Odense, Denmark.
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
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