Abstract
Despite the extensive possibilities of systemic treatment for advanced renal cell carcinoma have been still missing positive adjuvant trials. Several studies with immunotherapy based on interferon alfa or interleukin -2 failed.
The adjuvant trials with TKI concluded with conflicting results. The ASSURE study compared sunitinib or sorafenib with placebo was not able to detect any difference in diseases free survival compared to placebo and was associated with high rate of toxicity and discontinuation of treatment.
The adjuvant trial S-TRAC comparing sunitinib and placebo resulted in prolonged diseases free survival 6.8 years vs. 5.6 years. None of these trials incorporated a new validated genetic recurrence score to predict the risk of recurrence.
The adjuvant systemic treatment for renal cell carcinoma is not recommended in the clinical daily practise today.