To determine the patient's risk group, click here.
Favorable risk patients: Early nephrectomy
Intermediate risk patients: Primary systemic therapy and delayed nephrectomy.
Poor risk patients: Nephrectomy is not advised
Systemic Treatment for Clear Cell Histology
Favorable risk group:
Pembrolizumab (targeting PD-1)+ Axitinib (TKI)
Pazopanib (TKI), Sunitinib (TKI)
Intermediate and poor risk groups
Pembrolizumab plus Axitinib
Ipilimumab (targeting CTLA-4)+Nivolumab (targeting PD-1)
Metastasectomy is discussed with favorable risk patients.
Stereotactic radiotherapy for bone or brain metastases