Next Steps: Sequencing Therapies in Metastatic Kidney Cancer in the Contemporary Era

Andrew L Schmidt1, Alexandra L Tabakin2, Eric A Singer2

  • 1Lank Centre for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA.

Insights

First-line metastatic renal cell carcinoma treatment now uses immune checkpoint inhibitors. Managing advanced disease post-therapy requires integrated multidisciplinary care and novel systemic options.

Area of Science:

  • Oncology
  • Immunotherapy
  • Nephrology

Background:

  • First-line metastatic renal cell carcinoma (mRCC) treatment has shifted to immune checkpoint blockade combinations.
  • These combinations include PD-1/L1 inhibitors with CTLA-4 inhibitors or VEGF-targeted therapy.
  • This evolving paradigm presents challenges in integrating multidisciplinary care and subsequent therapies.

Purpose of the Study:

  • To outline data on multidisciplinary management of mRCC.
  • To review systemic therapy options post-immune checkpoint blockade.
  • To discuss novel therapies and future directions for advanced RCC.

Main Methods:

  • Review of available data on mRCC management.
  • Analysis of systemic therapy options in the post-IO setting.
  • Exploration of emerging therapies for advanced RCC.

Main Results:

  • Combination immunotherapy is the new standard for first-line advanced RCC.
  • Optimal integration of surgery, radiotherapy, and systemic therapy is crucial.
  • Several novel therapies are under investigation for advanced RCC.

Conclusions:

  • Clinicians face new challenges in managing advanced RCC post-combination therapy.
  • Multidisciplinary care and strategic sequencing of therapies are essential.
  • Continued research into novel agents and treatment strategies is vital for improving outcomes.

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