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University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Editor’s note: The role of cytoreductive nephrectomy (CN) in patients with metastatic renal cell carcinoma (mRCC) in the immunotherapy era is well established. In patients with good Eastern Co-operative Oncology Group performance status (PS) scores of 0–1, CN plus interferon-α-2b (IFN-α2b) has been shown to improve overall survival (OS) from 7.8 months to 13.6 months compared with IFN-α2b alone (J Urol 2004;171:1071–6). What, if any, benefit CN carries in the setting of targeted therapy (TT) remains unknown and is an important issue that urgently needs to be addressed. While we await results from studies such as CARMENA (French Clinical Trial to Assess the Importance of Nephrectomy), a Phase III trial randomizing high-PS patients to receive either sunitinib plus CN or sunitinib alone, what can we learn from retrospective datasets?