Treatment of Advanced or Metastatic Clear-Cell Renal Cell Carcinoma Without Contraindication to Immune Checkpoint Inhibitors

This protocol covers management of advanced or metastatic clear-cell renal cell carcinoma in patients who are eligible for immune checkpoint inhibitor therapy and have progressed on prior systemic treatment.

Clinical scenario

The patient has advanced or metastatic clear-cell renal cell carcinoma and has no contraindication to immune checkpoint inhibitors. Where ICI therapy is contraindicated or unavailable, a separate treatment pathway applies.

Treatment approach

Second-line management is guided by sequencing VEGFR tyrosine kinase inhibitor therapy, with the choice of agent determined by what was used in the prior line of treatment.

Preferred agents, sequencing algorithm, and additional options are detailed in the full protocol.

References

DOI: 10.1016/j.annonc.2024.05.537

  • In patients with a contraindication to ICIs, or where ICIs are not available, sunitinib, pazopanib or tivozanib may be used.
  • Sequencing VEGFR TKI therapy after PD-1-targeted first-line therapy is the SoC.
  • VEGFR-targeted agents that have not been previously used should be considered.
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