Please select the option that best describes you:
In a patient with de novo metastatic RCC s/p Ipi/Nivo with partial response and residual viable RCC on cytoreductive nephrectomy, would you add cabozantinib or other TKI prior to disease progression?
Would the lack of pathologic complete response on nephrectomy inform the decision to add TKI? Would the site of persistent metastatic disease (e.g., lung vs bone vs LN) inform the decision?
Answer from: Medical Oncologist at Community Practice
No, committing a patient to the substantial (and frequently occurring) adverse events of anti-VEGF TKIs like cabozantinib would require convincing evidence of clinically meaningful benefit, which is currently lacking in this setting. I am supportive of well-designed trials to explore these questions...
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Answer from: Medical Oncologist at Community Practice
Cytoreductive nephrectomy in asymptomatic patients is a controversial topic. There is some data suggesting clinical benefit to patients, but prospective data in the present checkpoint inhibitor era are needed. Fortunately, there are ongoing prospective clinical trials to provide this much-needed dat...