When, if ever, would you consider use of nivo/ipi for favorable risk metastatic ccRCC?
I do think about nivo/ipi for a subset of patients with favorable risk disease -- usually younger patients who are shooting for a complete response. In the favorable risk subset of patients in CheckMate 214, the complete responses are higher than even in the intermediate-poor risk. Patients who have...
For favorable risk disease, I consider single agent VEGF-TKI with careful discussion with patients about the pros and cons as there is no evidence to support improved outcomes with combination therapy. I would typically consider ipi and nivo in favorable risk only if there are other high risk featur...
If a patient is young and fit and interested in a treatment free period at some point, Ipi/nivo can be considered.
I have shied away from using nivolumab with ipilimumab for favorable risk metastatic RCC more recently. Although initially there was a suggestion that it may elicit higher complete response rates than other regimens, I think that we could probably elicit similar, if not higher response rates with ty...
I take into consideration the age of the patient and the expected duration of life. In younger patients, I may consider both agents Viz TKI and angiogenic inhibitor. Giving TKI alone for a couple of months and seeing if there is disease stabilization or response to continuing is not a bad choice in ...