Localized and metastatic clear cell renal cell carcinoma (ccRCC)

Authored by Sumanta Pal, published on 2026-05-21 21:38:34.0

  1. Renal cell carcinoma, clear cell subtype
    • Metastatic
      • Limited extent
        • Metastasectomy, SBRT
          • Meets KEYNOTE-564 eligibility criteria? M1 NED after local therapy?
            • Observation / individualized or systemic management
            • Pembrolizumab, one year
      • Extensive
        • Needs cytoreductive nephrectomy
          • Nivolumab / Ipilimumab
        • Does not need cytoreductive nephrectomy
          • Needs rapid disease control (symptomatic / aggressive disease)
            • Cabozantinib / nivolumab
          • Slower progression (asymptomatic / indolent disease)
            • Nivo/Ipi or Cabo/nivo
    • Localized
      • Low risk of recurrence
      • High risk of recurrence
        • High-risk disease per KEYNOTE-564?
          • Observation
          • Pembrolizumab, one year
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