Renal Cell Carcinoma
Systemic therapy for mRCC: second line and beyond

Tobias (61 years old)

Tobias is a 61-year-old postal service worker. His stamp collection never fails to impress at friends and family gatherings.

  • 4 years ago, he was diagnosed with mRCC (ccRCC, 2 lung metastases, IMDC intermediate risk) and started on sunitinib
  • After 1 year, his disease progressed on sunitinib and nivolumab was initiated
  • After 1.5 years on nivolumab, he progressed with a new metastatic lesion in the liver. Axitinib was initiated, with partial response at all metastatic sites 

Now, after 1.5 years on axitinib, the patient has disease progression at the existing metastatic sites.

Which treatment option would you choose for this patient?