Rohann J.M. Correa, MD, PhD
Abstract discussant Rohann J.M. Correa, MD, PhD, a radiation oncologist at London Health Sciences Centre and Assistant Professor at Western University, Canada, shared his insights on this landmark clinical trial for the treatment of kidney cancers.
“FASTRACK II represents an important milestone, being the first multicenter prospective clinical trial focusing on nonsurgical treatment for kidney tumors of significant size and complexity,” said Dr. Correa. He noted these “exceptional outcomes” add to the growing body of high-quality evidence supporting stereotactic body radiation therapy (SBRT) as a nonoperative kidney cancer treatment method. “I believe we owe it to our patients to inform them of all treatment options backed by high-quality evidence. In particular, our patients would want to know that SBRT is a completely noninvasive, convenient treatment option with minimal side effects and that it is incredibly effective.”
Dr. Correa underscored the treatment’s truly noninvasive nature, which makes it a suitable alternative, particularly for older patients who may have medical comorbidities or other competing risks that impact selection of management. This treatment can also be delivered with high precision without the need for fiducial markers, he said, eliminating the need for needles.
Rationale for SBRT
According to Dr. Correa, these findings justify the offering of SBRT as an option for patients in whom surgery is not possible. While active surveillance for small renal masses is appropriate, delayed intervention occurs in a significant portion of patients. These patients are often not well suited for surgery, and tumors may have grown larger or more complex than what is recommended for thermal ablative techniques; yet SBRT offered them a viable treatment, resulting in excellent outcomes.”
Finally, with respect to the future of treatment for kidney cancer, Dr. Correa agreed with Dr. Siva that surgery remains the standard of care. However, FASTRACK II has raised the question of whether patients may someday have an alternative to surgery to treat their localized kidney cancer, said Dr. Correa, and further research could eventually hold the answer.
“Further research is needed before we can recommend SBRT to treat localized kidney cancer for operable patients, but FASTRACK II sets the stage for this next step of a randomized controlled trial,” he concluded.
DISCLOSURE: Dr. Correa reported no conflicts of interest.
