The safety and efficacy of XXXX before planned nephrectomy in metastatic clear cell @entity703 .

@entity1 @entity2240 @entity5 @entity190 @entity532 @entity204 @entity703
BACKGROUND: The safety and efficacy of upfront @entity2240 , before nephrectomy in metastatic clear cell @entity703 (mCRC), has not been prospectively evaluated. METHODS: Two prospective single-arm phase II studies investigated either two cycles (study A: n = 19) or three cycles (study B: n = 33) of @entity2240 before nephrectomy in mCRC. RESULTS: Overall, 38 of 52 (73%) of @entity1 obtained clinical benefit (by RECIST) before surgery. The partial response rate of the primary @entity5 was 6% [median reduction in longest diameter of 12% (range 8%-35%)]. No @entity1 became ineligible due to local progression of disease. A nephrectomy was carried out in 37 (71%) of @entity1 . Necrosis (>50%) was a prominent feature at nephrectomy in 49%. @entity532 (Clavien-Dindo classification) occurred in 10 (27%) @entity1 , including one @entity204 (3%). The median @entity190 and surgical time were 725 (90-4200) ml and 189 (70-420) min, respectively. The median progression-free survival was 8 months (95% confidence interval 6-15 months). A comparison of two versus three pre-surgery cycles showed no significant difference in terms of surgical complications or efficacy. CONCLUSIONS: Nephrectomy after upfront @entity2240 can be carried out safely. It obtains control of disease. Randomised studies are required to address if this approach is beneficial.
