Combination Therapy as First-Line Treatment in Metastatic Renal-Cell Carcinoma

The treatment of metastatic renal-cell carcinoma has been revolutionized twice in the past 12 years by data showing that vascular endothelial growth factor (VEGF) inhibition can induce tumor shrinkage and increase progression-free survival and that immune checkpoint inhibitors can induce durable responses and increase overall survival among patients with this form of cancer. Guidelines for the treatment of metastatic renal-cell carcinoma have changed dramatically to recommend agents that target these two major pathways. In 2007, a trial showed that sunitinib, a tyrosine kinase inhibitor with potent VEGF inhibition, was superior to interferon alfa, and sunitinib became a new standard of . . .