The initial treatment of advanced or metastatic RCC is systemic therapy. Immune checkpoint inhibitors, either as a dual type (eg, nivolumab plus ipilimumab) or in combination with kinase inhibitors (eg, pembrolizumab plus axitinib), are standard of care treatment options. The selection of agents is based on disease-related symptoms, patient comorbidities, and tumor risk stratification. Combination immunotherapy has been accepted by guidelines following numerous studies demonstrating improvements in overall survival and progression-free survival. Single-agent immunotherapy may be an option for patients with favorable-risk tumors; however, immunotherapy-based combinations are preferred.
Interferon alpha has been replaced by immunotherapy with checkpoint inhibitors and targeted agents and is generally no longer used for the treatment of RCC.
An mTOR inhibitor in combination with a VEGF receptor inhibitor, such as lenvatinib plus everolimus, may be an option for intermediate- or poor-risk disease patients who are ineligible for immunotherapy or as second-line treatment.
Learn more about RCC.
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Cite this: Elwyn C. Cabebe. Fast Five Quiz: Relapsed and Metastatic Renal Cell Carcinoma - Medscape - Jul 08, 2022.