The therapy of advanced (clear-cell) renal cell carcinoma (RCC) has recently experienced tremendous changes. Several new treatments have been developed, with PD-1 immune-checkpoint inhibition being the backbone of therapy. Diverse immunotherapy combinations change current first-line standards. These changes also require new approaches in subsequent lines of therapy. In an expert panel, we discussed the new treatment options and how they change clinical practice. While first-line immunotherapies introduce a new level of response rates, data on second-line therapies remains poor. This scenario poses a challenge for clinicians as guideline recommendations are based on historical patient cohorts and agents may lack the appropriate label for their in guidelines recommended use. Here, we summarize relevant clinical data and consider appropriate treatment strategies.
Future oncology (London, England). 2020 Sep 23 [Epub ahead of print]
Peter J Goebell, Philipp Ivanyi, Jens Bedke, Lothar Bergmann, Dominik Berthold, Martin Boegemann, Jonas Busch, Christian Doehn, Susanne Krege, Margitta Retz, Gunhild von Amsberg, Marc-Oliver Grimm, Viktor Gruenwald
Division of Urology, University Hospital Erlangen, D-91054, Erlangen, Germany., Department of Hematology, Hemostaseology, Oncology & Stem Cell Transplantation, Hannover Medical School, D-30625, Hannover, Germany., Department of Urology, Eberhard Karls University, D-72076, Tuebingen, Germany., University Hospital Frankfurt, Medical Clinic II, D-60590, Frankfurt, Germany., Centre Hospitalier Universitaire Vaudois, CH-1011, Lausanne, Switzerland., Department of Urology, University Hospital Münster, D-48149, Münster, Germany., Department of Urology, Charité-University Medicine, D-10117, Berlin, Germany., Urologikum Lübeck, D-23566, Lübeck, Germany., Department of Urology, Pediatric Urology & Urologic Oncology, Kliniken Essen-Mitte, D-45136, Essen, Germany., Department of Urology, Technical University of Munich, Rechts der Isar Medical Center, D-81675, Munich, Germany., Department of Oncology & Hematology, University Cancer Center Hamburg & Martini-Clinic, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany., Department of Urology, Jena University Hospital, D-07747, Jena, Germany., Interdisciplinary GU Oncology, Clinic for Medical Oncology & Clinic for Urology, University Hospital Essen, D-45147, Essen, Germany.