First-line Treatment Considerations for Advanced/Metastatic Renal Cell Carcinoma

Combination therapies have revolutionized the first-line treatment of advanced/metastatic renal cell carcinoma (RCC), starting with dual immunotherapies and now, immunotherapy combined with a tyrosine kinase inhibitor (TKI). In this Roundtable, Dr Eric Jonasch is joined by Drs Andy Hahn and Chad Tang for a discussion on optimal uses for immunotherapy-TKI combination regimens in advanced/metastatic RCC.

In this Roundtable, Eric Jonasch, MD, Andy Hahn, MD, and Chad Tang, MD, explore how to effectively use immunotherapy–TKI combination regimens in advanced/metastatic renal cell carcinoma (RCC).

The panelists open by sharing insights on current prognostic algorithms that are used to define patient populations and inform the selection of optimal treatment in RCC. The tools discussed include the Memorial Sloan Kettering Cancer Center/Motzer score and International Metastatic RCC Database Consortium risk model.

Next, the physicians discuss how radiation therapy and other local modalities are playing an increasingly important role in metastatic RCC. They specifically highlight stereotactic body radiation therapy, a high-dose, precision radiation therapy that is effective and less damaging to adjacent tissues than conventional radiation therapy is.

The experts then highlight current systemic therapy recommendations and how to decide between immunotherapy-/immunotherapy or immunotherapy-TKI combinations for standard-risk, intermediate-risk, and poor-risk patients.

The experts continue by discussing key strategies for toxicity management.

The physicians conclude by covering approaches to brain and bone metastases, including whether to use whole brain or stereotactic radiation therapy.

About the Panel

Eric Jonasch, MD Photo

Eric Jonasch, MD

  • Professor
  • University of Texas MD Anderson Cancer Center
  • Houston, Texas
Chad Tang, MD Photo

Chad Tang, MD

  • Associate Professor, Radiation Oncology
  • University of Texas MD Anderson Cancer Center
  • Houston, Texas
Andy Hahn, MD Photo

Andy Hahn, MD

  • Assistant Professor, Genitourinary Medical Oncology
  • University of Texas MD Anderson Cancer Center
  • Houston, Texas
Disclosures

Eric Jonasch, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Aveo; Aravive; Callithera; Eisai; Exelixis; Ipsen; Merck; NiKang; Novartis; Takeda
Serve(d) as a speaker or a member of a speakers bureau for: DAVA
Received research grant from: Merck; NiKang; Arrowhead

Chad Tang, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Siemens Healthineers, Diffusion Pharmaceuticals, Bayer

Andrew W. Hahn, MD, has disclosed the following relevant financial relationships:
Received income in an amount equal to or greater than $250 from: Janssen
Received travel support from: Dava Oncology