What is your preferred third-line treatment for a patient with metastatic renal cell carcinoma who has had progression of disease on both initial VEGFR-TKI therapy and second-line nivolumab?

My preferred line treatment is based on the patients initial experience with the 2 prior therapies. If he is a "non-responder" to a VEGF TKI and then nivolumab, my third line choice is then everolimus plus lenvatinib as mTOR inhibition is a novel approach and efficicacy is improved in combination wi...

Cabozantinib can be even considered second line and keep Nivolumab as third line..

As @Dr. First Last notes, there is little to no evidence that response to prior TKI influences subsequent response, although this is commonly used in clinical practice. After TKI, then nivolumab, I think another TKI is the current standard of care outside of a clinical trial. There is retrospective ...