Dr Tsao on First-line Treatment Approaches in Clear Cell RCC

Che-Kai Tsao, MD, associate professor of medicine, Hematology and Medical Oncology, the Icahn School of Medicine at Mount Sinai, discusses first-line treatment approaches for patients with clear cell renal cell carcinoma (RCC).

The accelerated development of treatment options across different settings has provided novel agents and regimens for patients with RCC, Tsao begins. Specifically, regarding first-line options for patients with clear cell RCC, the emergence of different combination therapies has improved upon prior single-agent treatment patterns, he adds. The immunotherapy-based combination era has increased disease control for these patients, allowing them to experience improved survival, Tsao notes.

Combination therapies currently improved by the FDA in the frontline setting, such nivolumab (Opdivo) plus ipilimumab (Yervoy), lenvatinib (Lenvima) plus pembrolizumab (Keytruda), and nivolumab plus cabozantinib (Cabometyx), have provided a forward shift in the landscape for clear cell RCC, Tsao says.

Despite the availability of different combination options in the frontline setting, there is still not one-size-fits-all treatment approach for these patients, he notes, adding that there are not great biomarkers currently available to drive treatment decisions for these patients. However, it remains vital to focus on a personalized treatment approach, Tsao says. Patient factors, such as their goals of care and other components, could help inform frontline treatment decisions for patients with clear cell RCC, Tsao says.

From a disease perspective, risk, tumor location, symptoms, and genomics should also be used to recommend treatments for individual patients, Tsao expands. Reviewing treatment options with each patient is vital to provide the best personalized care, Tsao concludes.