How would you treat a patient with widely metastatic clear cell RCC who has undergone craniotomy/resection of a single brain metastasis?

Initial therapy in the front line setting for a person with widel metastatic disease would include either sunitinib or pazopanib. I would not use IL2 in this setting because of the recent brain surgery. Clinical trials should also be considered,

I agree with @Dr. First Last. Making sure surgical wounds are healed before starting TKI is important, otherwise you will end up holding drug and having wound healing issues.