For metastatic clear cell RCC, would you consider cabozantinib + nivolumab after progression on first line ipilimumab + nivolumab?

The management of metastatic clear cell RCC continues to evolve since the approval of nivolumab for salvage therapy post TKI tx. Given the activity of anti PD1 inhibition in the salvage setting, the field has investigated multiple combinations of such agents in the first line setting. The rationale ...

I would likely consider cabozantinib single agent if the patient has rapid and significant progression. If the patient had a prolonged response (>6 months) to ipi and nivo and is tolerating nivolumab well, then I would consider continuing nivolumab and adding cabozantinib. The CONTACT-03 trial is on...

Currently, if a patient progresses through immunotherapy, I generally do not continue immunotherapy. While there has certainly been exciting data for combination of Lenvatinib/pembrolizumab following progression on IO, I await results of ongoing randomized trials to determine the benefit of continui...

I would typically reserve cabozantinib with nivolumab for front-line treatment. Based on the CheckMate 9ER trial, the data for cabozantinib with nivolumab typically applies to the front-line setting as opposed to second-line therapy. In the second-line setting, I would consider enrollment after nivo...