[Contemporary treatment of metastatic clear cell renal cell carcinoma].

BACKGROUND: Renal cell carcinoma is one of the most common malignant tumors in Germany with an increasing incidence. Drug therapy is indicated in relapsed or metastatic disease.

MATERIALS AND METHODS: The article is based on the content of the recent guidelines and a selective literature search.

RESULTS: Combination therapies based on a checkpoint inhibitor are the current standard in first-line treatment of metastatic renal cell carcinoma. The median overall survival could thus be extended to > 50 months. The International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) score is used for risk classification. When selecting a suitable combination therapy, it is important to consider the advantages and disadvantages for each individual patient. There is currently no standard for follow-up therapies. So far, combination therapies have not shown any significant advantage in second-line treatment. It is recommended to switch to a substance that has not yet been used.

CONCLUSIONS: Currently, one purely immuno-oncology combination and four combinations of one immune checkpoint inhibitor and one tyrosine kinase inhibitor (TKI) are approved for first-line therapy in Germany. The added value of further intensification of therapy, in particular through triple combinations or further combination therapy in the second line, has not yet been proven.

© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

PMID: 39545945