An educational symposium was held from 8-10 August as part of the American Society of Clinical Oncology’s (ASCO) Annual Meeting. In his presentation, Dr Primo Lara from UC Davis Comprehensive Cancer Center in California discussed the first-line treatment of metastatic renal cell carcinoma (RCC), specifically whether combination therapy is better than single therapy (monotherapy).

Dr Lara highlighted the decisions that clinicians make regarding treatment options for patient with RCC, such as an assessment of the patient’s RCC risk (favourable, intermediate or poor), suitability for active surveillance, and the role of surgery. The assessment of suitability for drug treatment is driven by eligibility for treatment with immune checkpoint inhibitors based upon the patient’s RCC risk category.

In summary, Dr Lara highlighted the importance of assessing the patient’s RCC risk, consideration of the opinions of healthcare experts from different areas of medicine (multi-disciplinary input), and assessment of the patient for treatment with immunotherapy prior to decision making. For most patients, combination immunotherapy-based treatment (immunotherapy combinations or immunotherapy-VEGF-TKI combinations) should be considered standard of care with monotherapy limited to a small group of patients.

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