Trial reportThe Lancet. Oncology2016
Active surveillance in metastatic renal-cell carcinoma: a prospective, phase 2 trial.
Trial report in The Lancet. Oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 96 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
96 citing papers in PubMed, 3 syntheses or guidelines pooled it, 251 citations in OpenAlex.
- Delayed Versus Immediate Start of Chemotherapy in Asymptomatic Patients With Advanced Cancer: A Meta-Analysis.The oncologist · 2023Pooled it
- SEOM SOGUG clinical guideline for treatment of kidney cancer (2022).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2023Guideline
- Kidney Cancer, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology.Journal of the National Comprehensive Cancer Network : JNCCN · 2022Guideline
- Molecular Genetic Determinants of Shorter Time on Active Surveillance in a Prospective Phase 2 Clinical Trial in Metastatic Renal Cell Carcinoma.European urology · 2022Trial
- Definitive radiotherapy in lieu of systemic therapy for oligometastatic renal cell carcinoma: a single-arm, single-centre, feasibility, phase 2 trial.The Lancet. Oncology · 2021Trial
- Lesion detection by [European journal of nuclear medicine and molecular imaging · 2019Trial
- Effect of First-Line Combination Systemic Therapy on Favorable-Risk Clear Cell Renal Cell Carcinoma: A Retrospective Study.Biomedicines · 2026Article
- First-in-humanTheranostics · 2026Article
- Hong Kong Urological Association-Hong Kong Society of Uro-Oncology 2025 consensus on the management of locally advanced or metastatic renal cell carcinoma.Frontiers in oncology · 2026Review
- One size does not fit all: rethinking IO-TKI use in favorable-risk metastatic ccRCC.Frontiers in oncology · 2026Article
- First-Line Treatment Strategies in IMDC Favourable-Risk Metastatic Clear Cell Renal Cell Carcinoma.Oncology research · 2026Review
- Risk Factors for First-Year Recurrence in Patients With Synchronous Metastatic Renal Cell Carcinoma Undergoing Cytoreductive Nephrectomy and Complete Metastasectomy.The Journal of urology · 2025Article
- Beyond the Scalpel: the Role of Image-Guided Thermal Ablation in Management of Metastatic Renal Cell Carcinoma in the Era of Immunotherapy.Cardiovascular and interventional radiology · 2025Review
- First Single-Centre Experience with the Novel HIF-α Inhibitor Belzutifan in Switzerland.Current oncology (Toronto, Ont.) · 2025Article
- A synchronous lesion: Papillary renal cell carcinoma mistaken as an adrenal gland mass.Radiology case reports · 2025Article
- 2024 CUA-KCRNC Expert Report: Management of non-clear cell renal cell carcinoma.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2024Article
- Review
- The Treatment of Metastatic Renal Cell Carcinoma.Deutsches Arzteblatt international · 2024Review
- Contemporary Management of Renal Cell Carcinoma: A Review for General Practitioners in Oncology.Current oncology (Toronto, Ont.) · 2024Review
- Article
36 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
14 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundA subset of patients with metastatic renal-cell carcinoma show indolent growth of metastases. Because of the toxicity and non-curative nature of systemic therapy, some of these patients could benefit from initial active surveillance. We aimed to characterise the time to initiation of systemic therapy in patients with metastatic renal-cell carcinoma under active surveillance.
methodsIn this prospective phase 2 trial, we enrolled patients with treatment-naive, asymptomatic, metastatic renal-cell carcinoma from five hospitals in the USA, Spain, and the UK. Patients were radiographically assessed at baseline, every 3 months for year 1, every 4 months for year 2, then every 6 months thereafter. Patients continued on observation until initiation of systemic therapy for metastatic renal-cell carcinoma; a decision that was made at the discretion of the treating physician and patient. The primary endpoint of the study was time to initiation of systemic therapy in the per-protocol population. The follow-up of patients is ongoing.
findingsBetween Aug 21, 2008, and June 7, 2013, we enrolled 52 patients. Median follow-up of patients in the study was 38·1 months (IQR 29·4-48·9). In the 48 patients included in analysis, median time on surveillance from registration on study until initiation of systemic therapy was 14·9 months (95% CI 10·6-25·0). Multivariate analysis showed that higher numbers of International Metastatic Database Consortium (IMDC) adverse risk factors (p=0·0403) and higher numbers of metastatic disease sites (p=0·0414) were associated with a shorter surveillance period. 22 (46%) patients died during the study period, all from metastatic renal-cell carcinoma.
interpretationA subset of patients with metastatic renal-cell carcinoma can safely undergo surveillance before starting systemic therapy. Additional investigation is required to further define the benefits and risks of this approach.
fundingNone.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.