Dr. Joseph on Factors Influencing Frontline Therapy Selection in mRCC

Richard W. Joseph, MD, internist and oncologist, Mayo Clinic, discusses considerations for frontline therapy selection for patients with metastatic renal cell carcinoma (mRCC).

The first thing that needs to be to be taken into consideration is a patient’s risk status, whether it’s good, intermediate, or poor. Risk status was initially designed to be prognostic, but can also be used to predict biology, adds Joseph.

In addition to risk status, a patient’s comorbidities should also be used to guide therapy selection. For example, if a patient has a cardiac history, is anti-VEGF therapy the best choice? Additionally, any soft or hard contraindication to immunotherapy could help eliminate an immunotherapy-based therapy from the equation. Ultimately, the decision comes down to good clinical judgement, concludes Joseph.