Daniel George, MD, questions whether debulking nephrectomy is still necessary in the age of targeted therapies. In a one-sided non-inferiority study, sunitinib alone was compared to nephrectomy. The data suggested that sunitinib alone was not inferior to nephrectomy, however, patients who receive sunitinib may still be eligible for nephrectomy. This study, known as CARMENA, included a very wide range of patients in terms of tumor size and metastasis.
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