Optimizing First-Line Therapy in Advanced Renal Cell Carcinoma: Maximizing Response Depth Across Clear Cell and Non-Clear Cell Disease

This OncLive® NewsNetwork Presents program explores contemporary treatment strategies for patients with advanced renal cell carcinoma (RCC), with emphasis on individualized first-line treatment selection across clear cell and non-clear cell disease. Dr. Martin Voss and Dr. Michael Serzan discuss how histology, tumor biology, disease burden, clinical presentation, treatment goals, and patient-specific factors influence selection among immune checkpoint inhibitor and tyrosine kinase inhibitor-based regimens. The experts examine the importance of achieving early, deep, and durable responses, including the potential role of treatment de-escalation or consolidative approaches in selected patients with favorable responses. The discussion also addresses emerging evidence in non-clear cell RCC, including papillary, chromophobe, and FH-deficient disease, as well as treatment considerations following progression on immunotherapy. Finally, they review evolving evidence for subsequent-line therapies, including combination approaches and HIF-2α inhibition, while considering efficacy, toxicity, quality of life, and the role of ongoing clinical research in refining treatment sequencing.