Future Directions in the Management of Renal Cell Carcinoma


Shared insight on the evolving treatment landscape of renal cell carcinoma and expectations for future evolution in the paradigm.


Thomas Powles, MBBS, MRCP, MD: I think we're going to wrap this up now, if we may. I don't know if anyone has anything they'd like to say. I'm sure the audience would like to hear from each of you very briefly about what you feel about the future of the disease both in first-line, second-line and non–clear cell, and how you feel we're going to move forward in the future.

Benjamin Maughan, MD: In my last couple comments here, I will focus on the non–clear population. I'm really excited to see that we've moved away from large basket trials to individual approaches because there's a unique distinct biology for each of these between chromophobe and collecting duct and papillary and clear cell. We need a distinct approach for that disease. So, it’s wonderful to see the community rallying behind all these different trials.

Thomas Powles, MBBS, MRCP, MD: More working the perirenal cancer. Ulka, what is one thing that you'd like to fight this on the future, you'd like to see us do?

Ulka Nitin Vaishampayan, MBBS: We need to spell out the sequences better. All of these regimens have been in parallel and they've all been compared to sunitinib. We really haven't had a chance to optimize these regimens as to what happens after front line IO/IO (immuno-oncology/immuno-oncology) versus IO/TKI (immuno-oncology/tyrosine kinase inhibitor). What are the pros and cons of which way we should go going forward? I really think optimizing every treatment is essential.

Thomas Powles, MBBS, MRCP, MD: Focusing on that lack of data, that area where we didn't have enough information; really interesting. Rana?

Rana McKay, MD: We need new targets. We need new drugs. We figure if we're combining or putting triplets, sequencing. Now, we need some new players in the game.

Thomas Powles, MBBS, MRCP, MD: So, a new field to play in.

Rana McKay, MD: We need a new VEGF-TKI [vascular endothelial growth factor-tyrosine kinase inhibitor].

Thomas Powles, MBBS, MRCP, MD: A new VEGF-TKI. Eric, we're going to leave it with you if I may.

Eric Jonasch, MD: We need to go back to biology at this point. There are molecular tools now, there's single-cell sequencing, there's a spatial transcriptomics; there are things that allow us to answer biological questions in clinical trials that we weren't able to do 5 years ago. We, as an investigative community, have to do those trials together with pharma, together with academia, and that's going to bring our path forward. The other last thing is the patient voice. We've talked a lot about this; making sure that the patient voice is there for all of the trials that we design, all of the guidelines we create. This is going to be critical for us to move forward as well.

Thomas Powles, MBBS, MRCP, MD: We're going to end on the patient voice, it's a good place to end. Thank you very much for your attention and thank you very much for making my job so easy today. To our viewing audience, thank you for joining us; we hope you found theOncLive® peer discussion to be useful and valuable for treatment of patients with renal cell carcinoma. Thank you very much.

Transcript edited for clarity.

Related Videos
Jaime R. Merchán, MD, Sylvester Comprehensive Cancer Center
A panel of 4 experts on bladder cancer
A panel of 4 experts on bladder cancer
A panel of 5 experts on renal cell carcinoma
A panel of 5 experts on renal cell carcinoma
Brian I. Rini, MD, FASCO
Kathryn Beckermann, MD, PhD
Eleonora Dondossola, PhD
Tian Zhang, MD, MHS
Benjamin Garmezy, MD