Further-Line Treatment for Advanced or Metastatic Clear-Cell Renal Cell Carcinoma Without ICI Contraindication

This protocol addresses systemic therapy selection for patients with advanced or metastatic clear-cell renal cell carcinoma who have no contraindication to immune checkpoint inhibitors and require treatment beyond initial therapy.

Clinical Scenario

Advanced or metastatic clear-cell renal cell carcinoma, in patients without a contraindication to immune checkpoint inhibitors, where further-line systemic therapy is indicated.

Treatment Approach — Partial Overview

Further-line management in this setting involves sequencing of targeted therapy, with VEGFR tyrosine kinase inhibitor therapy among the approaches considered, guided by prior treatment history.

The complete sequencing algorithm, agent selection criteria, and further options remain in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.annonc.2024.05.537

Sequencing VEGFR TKI therapy or belzutifan can be recommended.
Belzutifan should be considered instead of everolimus in heavily pretreated patients (after PD-1- and VEGFR-targeted therapy).
Everolimus remains an option for patients who have received PD-1- and VEGFR-targeted therapy, but other approaches are preferable.

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