Experts weigh IO-TKI vs dual immunotherapy for metastatic ccRCC, highlighting rapid symptom relief, bone/brain response, survival outcomes, and toxicity tradeoffs.
Publication|Articles|October 15, 2024
Peers & Perspectives in Oncology
- October I 2024
- Pages: 40
Roundtable Roundup: First and Second Choices for Frontline RCC Therapy
Author(s)Targeted Oncology Staff
During separate virtual live events, David A. Braun, MD, PhD, and Rana R. McKay, MD, surveyed oncologists on options for a patient with clear cell renal cell carcinoma (RCC) in the front line.
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CASE SUMMARY
- A 59-year-old African American woman was diagnosed with a left renal mass.
- She underwent left radical nephrectomy in December 2019.
- Clear cell RCC
- T3aN0Mx, International Society of Urological Pathology grade 3
- Nine months later, she reported pain in hips and left chest.
- Radiographic diagnosis: stage IV RCC with osteolytic lesions in iliac crest and left fifth rib
- ECOG performance status: 1
- Laboratory results:
- Hemoglobin level: 11.1 g/dL
- Elevated liver function test results
- Mild hypercalcemia (10.8 mg/dL)
- Neutrophil and platelet counts: within normal limits
CASE UPDATE
The patient received nivolumab (Opdivo) plus ipilimumab (Yervoy).
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Daniel Heng, MD, discusses how belzutifan plus lenvatinib fills an unmet need after immunotherapy in RCC, with insights on managing hypoxia and anemia and on sequencing.
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