Gustavo (67 years old)

Gustavo, 67 years old, is a retired financial advisor. Nowadays, he is helping his whole neighbourhood obtain the biggest tax return possible. He was diagnosed with primary metastatic renal cell carcinoma (mRCC) 4 years ago.

Assessment summary 4 years ago:

• Metastatic sites: lung, bone, lymph nodes and adrenal gland
• No relevant past medical history
• International mRCC Database Consortium (IMDC): intermediate risk
• Biopsy of bone: histologically confirmed metastasis of clear-cell RCC (ccRCC)

Underwent laparoscopic cytoreductive nephrectomy on the right side 4 years ago:

• pT2a, no lymphatic or venous invasion, no residual tumour
• Grade 3 ccRCC

First-line therapy with sunitinib (50 mg/day) on a ‘4 weeks on, 2 weeks off’ schedule was initiated shortly thereafter.

Now, 4 years later: disease progression, metastatic sites: lung, bone, lymph nodes and adrenal gland.