Management of advanced kidney cancer: Kidney Cancer Research Network of Canada (KCRNC) consensus update 2021

Abstract

Advanced RCC has seen many treatment advances in the past several years, with the introduction of many novel therapies. Recent evidence from the KEYNOTE 426 and CheckMate 214 studies, and now the addition of the CheckMate 9ER and CLEAR studies, has mandated a rearrangement of treatment algorithms for advanced clear-cell RCC with the use of doublet immunotherapy or immunotherapy in combination VEGFR-TKI. We now await both clinical experience, prospective clinical trials, and development of predictive biomarkers to help inform the optimal choice and sequence of currently available treatment options. In absence of head-to-head comparison between combination approaches at this time, therapy should be individualized based on patient profiles and disease characteristics, and each agent chosen should be optimized to obtain the best results, with multidisciplinary care being paramount in achieving maximal benefit for patients. Ongoing participation in research and clinical trials to further our knowledge in this field continues to be an essential priority for healthcare professionals with an interest in advanced RCC.