Active surveillance after surgery still best approach for kidney cancer
15 Oct 2020
Results from the SORCE trial confirm that the drug sorafenib should not be used as treatment straight after surgery for kidney cancer. These results were published yesterday in the Journal of Clinical Oncology.
The results confirm that active surveillance, where patients are closely monitored for signs of the disease coming back or getting worse, remains the standard of care for patients at intermediate or high risk of recurrence after surgical removal of their primary cancer. This approach is being used as the control of our current international adjuvant kidney cancer trial, RAMPART.
The SORCE trial recruited 1,711 patients with kidney cancer after they had surgery to remove their cancer. They were randomly allocated to receive one of three treatments:
- Three years of active surveillance and a placebo (dummy treatment)
- One year of treatment with a drug called sorafenib, followed by two years of placebo
- Three years of treatment with sorafenib
We observed no benefit for disease-free survival or overall survival following up to three years of sorafenib treatment. Moreover, 6 in 10 patients who received treatment experienced severe side-effects. A reduction in the initial starting dose improved treatment compliance, but despite offering treatment adaptations, over half of patients stopped treatment by 12 months.