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

Robert (82 years old)

Robert, 82 years old, was diagnosed with pancreatic metastases from clear-cell RCC (ccRCC) which occurred 12 years from nephrectomy.

Assessment summary:

  • Medical history
    • Hypertension controlled by antihypertensive drugs
    • Aortic stent placement 7 years ago
    • Left radical nephrectomy 12 years ago (ccRCC of 3.1 cm, ISUP grade 2, surgical staging pT1 N0)
  • ECOG PS: 0
  • KPS: 90%
  • CT scan: progressive hypervascular lesions of the pancreas (biopsy-proven metastases of ccRCC)
  • Blood work:
    • Haemoglobin: 11.8 g/dl (12-13 g/dl)
    • Neutrophils: 7.2x109/l (2.0-7.0x109/l )
    • Platelets: 455x109/l (150-400x109/l)
    • Calcium: 10.1 mg/dl (8.5-10.2 mg/dl)
    • LDH: 350 U/l (135-225 U/l)
  • Geriatric screening: patient considered candidate for oncologic treatment, with controlled comorbidities and a Geriatric 8 (G8) screening tool score of 15/17*

*healthy patients with a G8 score >14 should receive the same treatment as younger patients according to SIOG guidelines

Which treatment option would you choose for this patient?