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October 27, 2016

Perioperative Management of Localized Kidney CancerWatching and Waiting

Author Affiliations
  • 1Memorial Sloan Kettering Cancer Center, New York, New York
JAMA Oncol. Published online October 27, 2016. doi:10.1001/jamaoncol.2016.4409

With the successful development of 10 molecularly targeted agents during the course of the past decade, the management of metastatic renal cell cancer (RCC) has seen unparalleled progress owing to better understanding of the molecular biology of this disease.1 In contrast to these advances made for patients with disseminated disease, randomized clinical trials in the nonmetastatic setting have been largely unsuccessful, and the standard of care for resectable stages I to III disease remains nephrectomy followed by active surveillance. In this issue of JAMA Oncology, Chamie and colleagues2 report on the results of ARISER (Adjuvant Rencarex [Girentuximab] Immunotherapy Trial to Study Efficacy in Nonmetastatic Renal Cell Carcinoma), a double-blind phase 3 study comparing 12 weeks of adjuvant treatment with girentuximab, a chimeric carbonic anhydrase IX (CAIX)–directed monoclonal antibody, with placebo in patients with nonmetastatic high-risk RCC who underwent nephrectomy. The study, conducted internationally in 864 patients across 142 centers, failed to meet its primary aim of prolonging disease-free survival (DFS) and ultimately demonstrated no significant difference between the 2 treatment groups (hazard ratio, 0.97; 95% CI, 0.79-1.18).

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