Next Steps: Sequencing Therapies in Metastatic Kidney Cancer in the Contemporary Era

Systemic therapy for first-line metastatic renal cell carcinoma has evolved toward immune checkpoint blockade combinations incorporating a PD-1/L1 inhibitor along with CTLA-4 inhibition or VEGF-targeted therapy. The new treatment paradigm that integrates immunotherapy treatment-naïve advanced creates therapeutic challenge clinicians including the optimal way to integrate multidisciplinary care involving surgery, radiotherapy, and application of contemporaneous systemic in subsequent lines following discontinuation combination We outline available data management carcinoma, options post–immune setting, novel therapies development carcinoma. provide practical considerations assist choice map future directions progress.