What is your preferred regimen for metastatic clear cell RCC following progression on IO/TKI?

Patients with progression after IO-based therapies are increasingly common. Standard options include single agent TKI (cabozantinib most commonly used after axi/pembro) and lenvatinib/everolimus. The role of additional IO-based therapy in this setting is unproven, although there are data with lenvat...

Treatment following progression on IO/TKI depends on the regimen chosen in the front line. We have pursued retrospective analysis showing that cabozantinib maintains efficacy independent of toxicity following IO (McGregor et al., PMID 32599410) and this was confirmed in prospective setting with CANT...

For this patient, I would choose cabozantinib or potentially the combination of cabozantinib-nivolumab if the patient was tolerating immunotherapy well. The pattern and cadence of progression from first-line treatment also play a part in my decision making. For example, if a patient had early progre...