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In 2015, the standard treatment for most patients with advanced kidney cancer was a vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor (TKI) such as sunitinib or pazopanib for untreated patients, followed by a checkpoint inhibitor (PD-1 inhibitor) such as nivolumab for patients who fail treatment with a VEGF inhibitor. However, over the last several years, there has been a raft of clinical trials showing that if you combine VEGF inhibitors with PD-1 inhibitors, you can get better outcomes than with a VEGF inhibitor alone.
This paper discusses how the standard of care for untreated patients with advanced renal cell carcinoma (RCC) has shifted from a VEGF TKI alone to a combination of checkpoint inhibitor plus either a VEGF TKI or a CTLA-4 inhibitor.