Please select the option that best describes you:
Topics:
Genitourinary Cancers • Medical Oncology • Renal Cell Carcinoma • NCI-CCC Tumor Board Question • UCSF • NCI-CCC GU Tumor Board Question
What is your preferred regimen for metastatic clear cell RCC following progression on IO/TKI?
Patient has progression of liver metastases while on pembrolzumab/axitinib. ECOG PS 1 and limited comorbidities.
Answer from: Medical Oncologist at Academic Institution
Patients with progression after IO-based therapies are increasingly common. Standard options include single agent TKI (cabozantinib most commonly used after axi/pembro) and lenvatinib/everolimus. The role of additional IO-based therapy in this setting is unproven, although there are data with lenvat...
Sign in or Register to read more
Answer from: Medical Oncologist at Academic Institution
Treatment following progression on IO/TKI depends on the regimen chosen in the front line. We have pursued retrospective analysis showing that cabozantinib maintains efficacy independent of toxicity following IO (McGregor et al., PMID 32599410) and this was confirmed in prospective setting with CANT...
Answer from: Medical Oncologist at Community Practice
For this patient, I would choose cabozantinib or potentially the combination of cabozantinib-nivolumab if the patient was tolerating immunotherapy well. The pattern and cadence of progression from first-line treatment also play a part in my decision making. For example, if a patient had early progre...