How would you treat a patient with metastatic RCC with high grade neuroendocrine and sarcomatoid features after progression on IO + TKI?  

This is quite limited information. What is the underlying diagnosis, unclassified or something else like clear cell? Remember that sarcomatoid (and rhabdoid for that matter) are states of differentiation and not a true histologic diagnosis. We often think of the presence of neuroendocrine features a...