Consensus paper: current state of first- and second-line therapy in advanced clear-cell renal cell carcinoma

Future Oncol. 2020 Oct;16(29):2307-2328. doi: 10.2217/fon-2020-0403. Epub 2020 Sep 23.


The therapy of advanced (clear-cell) renal cell carcinoma (RCC) has recently experienced tremendous changes. Several new treatments have been developed, with PD-1 immune-checkpoint inhibition being the backbone of therapy. Diverse immunotherapy combinations change current first-line standards. These changes also require new approaches in subsequent lines of therapy. In an expert panel, we discussed the new treatment options and how they change clinical practice. While first-line immunotherapies introduce a new level of response rates, data on second-line therapies remains poor. This scenario poses a challenge for clinicians as guideline recommendations are based on historical patient cohorts and agents may lack the appropriate label for their in guidelines recommended use. Here, we summarize relevant clinical data and consider appropriate treatment strategies.

Keywords: RCC; TKI; VEGFR inhibitor; advanced (clear-cell) renal cell carcinoma; checkpoint inhibition; mTOR inhibitor; tyrosine kinase inhibitor.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor
  • Carcinoma, Renal Cell / diagnosis*
  • Carcinoma, Renal Cell / etiology
  • Carcinoma, Renal Cell / therapy*
  • Clinical Decision-Making
  • Clinical Trials as Topic
  • Combined Modality Therapy / adverse effects
  • Combined Modality Therapy / methods
  • Disease Management
  • Disease Susceptibility
  • Humans
  • Kidney Neoplasms / diagnosis*
  • Kidney Neoplasms / etiology
  • Kidney Neoplasms / therapy*
  • Neoplasm Staging
  • Practice Guidelines as Topic
  • Retreatment
  • Treatment Outcome


  • Biomarkers, Tumor