Renal Cell Carcinoma
INACTIVE --- First-line systemic therapy in mRCC

Iris (67 years old)

Iris, 67 years old, was diagnosed with mRCC about 2 years ago after admission to the emergency department with macroscopic haematuria.

About 2 years ago:

  • CT scan: right renal mass and 2 small lung nodules in right upper lobe (3 and 5 mm)
  • Underwent cytoreductive nephrectomy (clear-cell RCC, no sarcomatoid/rhabdoid features)

Lost to follow-up, now:

  • CT scan: increase of both lung nodules (4 vs 3 mm and 7 vs 5 mm) and appearance of multiple lung nodes up to 10 mm
  • CT-guided lung biopsy: confirmed metastatic ccRCC
  • No symptoms
  • ECOG PS: 0
  • KPS: 90%
  • Blood work: normal

Which treatment option would you choose for this patient?