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How would you treat a patient with widely metastatic clear cell RCC who has undergone craniotomy/resection of a single brain metastasis?
In the setting of recent craniotomy and a plan for SRS to the surgical cavity, which systemic therapy would you choose and when would you start it?
Answer from: Medical Oncologist at Academic Institution
Initial therapy in the front line setting for a person with widel metastatic disease would include either sunitinib or pazopanib. I would not use IL2 in this setting because of the recent brain surgery. Clinical trials should also be considered,
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Answer from: Medical Oncologist at Academic Institution
I agree with @Robert A. Figlin. Making sure surgical wounds are healed before starting TKI is important, otherwise you will end up holding drug and having wound healing issues.