Therapeutic Approach for Metastatic Renal Cell Carcinoma - Episode 6
Neeraj Agarwal, MD:What do I do when this patient experiences disease progression on cabozantinib? I think I base my decision or therapy selection for the second line, when second-line therapy is concerned, on the volume of disease or rapidity of disease progression. If the disease is progressing mildlythe pace is slow, indolent—I would choose nivolumab, because then I’m not really worried about not experiencing a progression-free survival benefit with nivolumab.
On the other hand, if this disease is rapidly progressing with multiple new lesions, including liver lesions, on cabozantinib, I would choose the lenvatinib/everolimus combination, because that combination has been shown to have remarkably high rates of objective response, which have not been seen by any other monotherapy so far in metastatic renal cell carcinoma.
Transcript edited for clarity.
Case Scenario: A 73-year old female with rapidly progressing mRCC