But he would also consider frontline double-IO combinations or an IO/TKI combination, a big change from treatment a decade ago, he said.

For those in the intermediate- or poor-risk categories, Thomas would consider debulking nephrectomy. “There are a lot of new first-line therapies.” If the patient has no contraindications, Humeniuk said he uses double IO or IO/VEGF-TKI combination therapies.Īdvanced RCC, although a fairly loose descriptor, is unlikely to be surgically curable, so patients with metastatic RCC in the favorable-risk category based on the International Metastatic RCC Database Consortium (IMDC) scale may be just observed initially, Thomas said. “I never use monotherapy anymore, like sunitinib or pazopanib ,” said Michael Humeniuk, MD, a hematologist/oncologist at the SMC Center for Hematology/Oncology in Spartanburg, South Carolina. These regimens mark a shift away from monotherapy, as seen in data shared at the 2021 Genitourinary (GU) Cancers Symposium, which highlighted a move toward combinations of immuno-oncology (IO) agents or an IO agent combined with a tyrosine kinase inhibitor (TKI), including VEGF inhibitors.

A handful of novel combination therapies have been approved for the frontline setting in the past few years, with others now in trials. But we don’t think we can routinely cure kidney cancer yet.”Īlthough curing advanced RCC is an admirable goal, there are many treatment options available on the horizon that result in substantial improvements in long-term outcomes. “Sometimes patients are on the drugs for 5 years with no evidence of disease. Although there is resistance to use the word “cured” to describe patients with long-term progression-free survival (PFS) in renal cell carcinoma (RCC), “that word sometimes gets whispered around the meetings,” Christian Thomas, MD, director of clinical research at New England Cancer Specialists in Scarborough, Maine, said in an interview with Targeted Therapies in Oncology.

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