PADRES: Neoadjuvant Axitinib for Complex Partial Nephrectomy

What is it about?

This study, PADRES, investigated the use of neoadjuvant axitinib for patients with clear-cell renal cell carcinoma (RCC) and imperative indications for partial nephron-sparing surgery (PN). Axitinib, administered twice daily for 8 weeks, resulted in reductions in tumor diameter and RENAL score, enabling safe and feasible PN and functional preservation. In the 27 enrolled patients, 74% had ≥ clinical T3a staged tumors prior to therapy, and 96.2% had negative margins after PN. The primary outcome was successful completion of planned PN following axitinib treatment, which was achieved in 74% of patients. Secondary objectives included changes in tumor diameter, RENAL nephrometry score, renal function, and Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, and surgical complications. Adverse events were hypertension and fatigue, with no grade 4/5 events reported. These findings suggest that neoadjuvant axitinib was successful in cytoreduction of renal masses and facilitated nephron preservation by allowing PN in circumstances where such an operation may not otherwise have been safe or effective. [Some of the content on this page has been created by AI]

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Why is it important?

The study is important because it investigates the use of neoadjuvant axitinib for patients with complex renal masses and imperative indication for partial nephron-sparing surgery. The results show that neoadjuvant axitinib resulted in reductions in tumor diameter and complexity, enabling safe and feasible partial nephron-sparing surgery and functional preservation in patients with complex renal masses and imperative indication. Key Takeaways: 1. The study investigated the use of neoadjuvant axitinib for patients with complex renal masses and imperative indication for partial nephron-sparing surgery. 2. Neoadjuvant axitinib resulted in reductions in tumor diameter and complexity, enabling safe and feasible partial nephron-sparing surgery and functional preservation in patients with complex renal masses and imperative indication. 3. The study found that neoadjuvant axitinib resulted in a 19% reduction in median tumor diameter, a significant reduction in RENAL nephrometry score, and clinical downstaging in 33% of patients.