# CARMENA

Source: https://onco.cc/trials/carmena/  
OnCo record `carmena` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

CARMENA showed that removing the kidney before starting sunitinib did not help people with kidney cancer that had already spread live longer, which ended the routine practice of upfront nephrectomy for intermediate- and poor-risk patients.

## Summary

Removing the primary kidney tumour before systemic therapy had been standard since trials in the interferon era showed a survival benefit. CARMENA, a French non-inferiority phase 3 trial, randomised 450 patients with metastatic clear cell renal cell carcinoma of MSKCC intermediate or poor risk to nephrectomy followed by sunitinib or to sunitinib alone. The primary endpoint was overall survival.

Sunitinib alone was non-inferior to nephrectomy plus sunitinib for overall survival, and the poor-risk group did numerically better without surgery. Together with the SURTIME trial it moved practice towards starting systemic therapy first and reserving nephrectomy for selected patients with a good response or few metastases; the question is being revisited in the immunotherapy era.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-17
- Tags: subtype-trials
- Registry id: NCT00930033
- Phase: 3
- Setting: Metastatic clear cell renal cell carcinoma of intermediate or poor risk: cytoreductive nephrectomy followed by sunitinib against sunitinib alone
- Sponsor: Assistance Publique - Hopitaux de Paris
- Enrolled: 452
- Result: Sunitinib alone was non-inferior to cytoreductive nephrectomy plus sunitinib for overall survival in intermediate- and poor-risk metastatic clear cell renal cell carcinoma.

## Sources

- ClinicalTrials.gov NCT00930033: https://clinicaltrials.gov/study/NCT00930033

## Connected records

- cancers: [Clear cell renal cell carcinoma](https://onco.cc/cancers/clear-cell-rcc/), [Renal cell carcinoma](https://onco.cc/cancers/rcc/)
- drugs: [Sunitinib](https://onco.cc/drugs/sunitinib/)
- people: [Arnaud Méjean](https://onco.cc/people/arnaud-mejean/)

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JSON: https://onco.cc/api/v1/entities/carmena.json