Renal Cell Carcinoma
Local therapy for mRCC

Nadia (56 years old)

Nadia, a 56-year-old woman, was diagnosed with metastatic ccRCC 5 years ago and has been treated with sunitinib ever since. Although several pulmonary metastases are seen still seen on the CT scan, she still has a partial response. The primary tumour appears to be largely necrotic on imaging.

Assessment summary:

  • ECOG PS: 0
  • KPS: 90%
  • Suffers from severe toxicity related to sunitinib (uncontrolled hypertension, hyperthyroidism)
  • Blood work:
    • Decreased TSH
    • Elevated T3 and T4
    • Otherwise normal

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