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Kotecha et al. J Cancer Metastasis Treat 2021;7:67 Journal of Cancer
DOI: 10.20517/2394-4722.2021.163
Metastasis and Treatment

Review Open Access

Novel standards and emerging therapies for
systemically treatment-naïve clear cell renal cell

carcinoma - a rapidly changing landscape

Ritesh R. Kotecha, Martin H. Voss
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Correspondence to: Dr. Martin H. Voss, Department of Medicine, Memorial Sloan Kettering Cancer Center, 300 East 66th
Street, New York, NY 10065, USA. E-mail: vossm@mskcc.org

How to cite this article: Kotecha RR, Voss MH. Novel standards and emerging therapies for systemically treatment-naïve clear
cell renal cell carcinoma - a rapidly changing landscape. J Cancer Metastasis Treat 2021;7:67. https://dx.doi.org/10.20517/2394-
4722.2021.163

Received: 10 Aug 2021 First Decision: 14 Sep 2021 Revised: 19 Sep 2021 Accepted: 28 Oct 2021 Published: 5 Dec 2021

Academic Editor: Hendrik Van Poppel Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
The last decade has brought about major advances in systemic therapy for patients with advanced clear cell renal
cell carcinoma. The introduction of angiogenesis targeting agents, immune checkpoint inhibitors, and combinations
thereof has resulted in a multitude of therapeutic standards for patients with newly diagnosed advanced disease.
With the rapid adoption and increasing number of available options for patients, selection amongst treatment
regimens has become complex. Further, a new balance is also being sought to optimize treatment outcomes and
limit treatment-related toxicities. With a rising bar against which novel therapeutics are being measured, the field
looks toward an evolved understanding of tumor biology to help pave new ways forward for individualized therapy.
Here, we review pivotal studies that led to regulatory approvals and ongoing clinical trials conducted in patients
with systemically untreated clear cell renal cell carcinoma and provide perspective on how newly emerging data
can be integrated into this rapidly changing landscape.

Keywords: Renal cell carcinoma, combination immunotherapy, clinical trials, first-line

INTRODUCTION
Over the last two decades, the clinical management of advanced clear cell renal cell carcinoma (ccRCC) has

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
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