Over the last decade, tyrosine kinase inhibitors and immune checkpoint inhibitors have revolutionized the treatment landscape for patients with metastatic renal cell carcinoma (mRCC). Currently, immunotherapy-based combination therapy (i.e. pembrolizumab-axitinib, avelumab-axitinib, nivolumab-ipilimumab) is the preferred first line treatment option for patients with mRCC. But even with these regimens the complete response rate is limited at approximately 8–9%. In this context, metastasis directed therapy (MDT) remains the only potentially curative treatment option for patients with mRCC. During the 2021 BMUC meeting, Prof. Shankar Siva (Peter McCallum Cancer Centre, Melbourne, Australia), discussed the current state of affairs with respect to MDT in the contemporary mRCC treatment landscape.
Immunotherapy has become a successful modality in the treatment of a number of cancers. Still, generally not more than one third of the patients respond well to this type of therapy. To improve the outcome, researchers are evaluating combinations with other modalities, such as radiotherapy. During BMUC 2019, radiation oncologist dr. Shankar Siva presented the results obtained with local radiotherapy and immunotherapy, and discussed the optimal sequence, timing and dosing of this combination treatment.