What is your preferred 3rd line therapy for patients with metastatic sarcomatoid RCC?

There is no standard 3rd line therapy for sarcomatoid RCC. We know from gene expression data and clinical trials that sarcomatoid RCC tend to be more responsive to immune therapy than VEGF-targeted therapy, so I would be tempted to find a clinical trial with a novel IO agent. If unavailable, one cou...

At the risk of a case report directing therapy, I would review the patient's experience with ipilimumab and nivolumab. If the patient progressed with induction ipilimumab and nivolumab, then the third line therapies Dr. @Dr. First Last suggested (especially a clinical trial if one is available) are ...