Renal Cell Carcinoma
First-line systemic therapy in metastatic renal cell carcinoma

Mariam (58 years old)

Mariam, a 58-year-old smoker was diagnosed with chromophobe mRCC after incidental discovery of a right renal mass during follow-up of multiple nodules in the lung. 

Assessment summary:

  • CT scan: right renal mass, multiple lung metastases
  • cT2aN0M1
  • Renal biopsy: chromophobe RCC
  • ECOG PS: 1
  • KPS: 80%
  • No contra-indications to immunotherapy or VEGFR-TKI therapy
  • Blood work:
    • Haemoglobin: 9.7 g/dl (12-13 g/dl)
    • Platelets: 129x109/l (150-400x109/l)
    • Otherwise normal

Which of the following treatment options would you choose for this patient?