A phase 2 study published in the British Journal of Urology last year evaluated the effectiveness of neoadjuvant axitinib given before surgery to reduce the size of renal tumours (stage cT2a) to enable partial nephrectomy in 18 patients.
The tumours decreased in size in 16 of the 18 patients, and these 16 patients had a partial nephrectomy. However, 6 patients developed metastases and 2 patients had recurrent renal cancer in the two years following the partial nephrectomy.
Neoadjuvant axitinib is successful at reducing the size of renal tumours; however, the the use of partial versus radical nephrectomy for a cT2 tumour remains controversial. Other studies to investigate neoadjuvant treatments, including checkpoint inhibitors, are forthcoming to find the best way to manage these tumours.