Wesley A. Mayer, MD, presented “The Bottom Line: Practical Application of Clinical Trial Data to Advanced Renal Cell Carcinoma” during the 23rd Annual Innovations in Urologic Practice on September 14, 2018 in Santa Fe, New Mexico.

How to cite: Mayer, Wesley A.. “The Bottom Line: Practical Application of Clinical Trial Data to Advanced Renal Cell Carcinoma?” September 14, 2018. Accessed Jul 2024. https://grandroundsinurology.com/the-bottom-line-practical-application-of-clinical-trial-data-to-advanced-renal-cell-carcinoma/

The Bottom Line: Practical Application of Clinical Trial Data to Advanced Renal Cell Carcinoma – Summary:

Wesley A. Mayer, MD, reviews the landmark trials that set the standard of care for cytoreductive nephrectomy (CN) and the impact of targeted therapy on this technique. He discusses recent clinical trials on CN and targeted therapy, as well as data regarding cytoreductive partial nephrectomy.


Although the 5-year survival rate for localized kidney cancer is 93%, it is dismal for metastatic disease. Two landmark randomized prospective multicenter trials, a SWOG study and an EORTC study, demonstrated level 1 evidence for a survival benefit over interferon alone in 2001. This generated the adoption of CN into common practice.

However, the discovery of some of the mechanisms behind the molecular basis of kidney cancer resulted in a prolific growth of drug development. 

Ultimately, this led to approval of 11 novel agents for targeted treatment of metastatic kidney cancer between 2005 and 2018. This resulted in significant changes in the utilization of cytoreductive nephrectomy. Until recently, only retrospective data was available concerning the outcomes of cytoreductive nephrectomy in this new era of targeted therapy.

This presentation reviews 2 recent randomized multicenter prospective surgical trials and how their outcomes might impact the treatment of metastatic kidney in the future. The conversation also briefly covers feasibility and outcomes of cytoreductive partial nephrectomy.

About Innovations in Urologic Practice

Innovations in Urologic Practice (IUP) is an annual CME-accredited conference devoted to updating urologists on the rapidly changing healthcare environment. Topics focus on innovative diagnostic and treatment strategies, controversies, new and currently developing technologies, and challenges in today’s urologic practice. Dr. Mayer presented this lecture during the 23rd IUP in 2018. Please visit this page in order to learn more about future IUP meetings.


Wesley A. Mayer, MD, is an associate professor of urology, the vice chair for education of the Scott Department of Urology, and an assistant dean of graduate medical education at Baylor College of Medicine in Houston, Texas. Dr. Mayer earned his medical degree from Baylor College of Medicine, graduating with highest honors. He completed his internship in general surgery and his urology residency at the University of Pennsylvania in Philadelphia, Pennsylvania. Dr. Mayer is fellowship-trained in advanced robotic, laparoscopic, and endoscopic surgery in Baylor College of Medicine’s Scott Department of Urology.

Dr. Mayer specializes in advanced minimally invasive surgical treatments for urologic diseases including robotic, laparoscopic (including single-site), endourologic, and percutaneous surgery. He has a special interest in kidney cancer, kidney stones, upper urinary tract reconstruction, adrenal masses, and transplant urology. He has also published research and has been invited to speak on these topics at several national and international conferences. Dr. Mayer has been repeatedly selected as a “Top Urologist in Houston, Texas” in The Leading Physicians of the World and a “Top Doc” in Houstonia Magazine.

Dr. Mayer is an accomplished educator. He received prestigious Norton Rose Fulbright Faculty Excellence Awards for educational leadership, as well as for teaching and evaluation. He was nominated for the 2020 Distinguished Faculty Award at Baylor College of Medicine and for a national teaching award from the Resident and Fellows Committee of the American Urological Association (AUA). Dr. Mayer has been an invited faculty member for several national educational courses, including the AUA’s Annual Oral Board Examination Review course and the AUA’s Mentored Laparoscopy course. Dr. Mayer served on the Accreditation Council for Graduate Medical Education’s (ACGME) Urology Milestones 2.0 Working Group, which created competency-based developmental outcome goals used by all accredited urology residency programs in the United States. He has participated in a number of task forces for the Society of Academic Urologists and for the ACGME’s Urology Standing Panel for Accreditation Appeals. Dr. Mayer has published widely on innovations in surgical education, co-authoring over 30 publications on cutting-edge surgical technology and techniques, and he has been an invited panelist at numerous national and international conferences concerning a variety of topics in education.