[First-line treatment of metastatic renal cell carcinoma]

In recent years the first-line treatment of metastatic renal cell carcinoma was revolutionized by the introduction of checkpoint inhibitors (CPI). Within a few years several combined modality treatments with CPI and tyrosine kinase inhibitors (TKI) have proven to be effective and safe in the application. According to the guidelines, up to five different combined modality treatments can now be considered, depending on the risk profile. Based on the current data situation, a direct distinction between the treatments cannot be made as no comparative studies are available. Therefore, the decision for a particular treatment is often guided by individual factors. In particular, a clear processing of the patient with the respective risk factors and tumor identity is essential. Hence, it is all the more important to discuss complex cases in an interdisciplinary tumor board.