Dr. Grigg on Sequencing in Renal Cell Carcinoma

Claud M. Grigg Jr, MD, medical oncologist, Levine Cancer Institute-Ballantyne, Atrium Health, discusses sequencing challenges in renal cell carcinoma (RCC).

Although sequencing is a challenge, determining what agent to start a patient on in the frontline setting is proving to be even more difficult, says Grigg, particularly because clear cell RCC can manifest in many different clinical presentations. The disease can be very aggressive or very indolent, but physicians may not necessarily know that upfront. Learning how to risk-stratify patients from the outset and then how to choose the right therapy from the start based on efficacy and tolerability is key, adds Grigg.

The use of TKI monotherapy will not have as much of an impact on treatment moving forward as it once had in the past. Now, combinations of VEGF TKIs and immunotherapy are showing greater efficacy and are likely to take over the frontline setting for the majority of patients. Ultimately, time will tell, concludes Grigg.