Renal Cell Carcinoma
Local therapy for mRCC

Gloria (58 years old)

Gloria is a 58-year-old motorcycle instructor. 2 years ago, she was diagnosed with metastatic ccRCC and has been treated with nivolumab + ipilimumab for 12 weeks followed by nivolumab monotherapy ever since. Although several pulmonary metastases are still seen on the CT scan, she has a partial response. The primary tumour appears to be largely necrotic on imaging.

Assessment summary:

  • ECOG PS: 0
  • KPS: 90%
  • Blood work: normal

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