The randomised phase III clinical trial Checkmate-214 showed a survival superiority for the combination of ipilimumab and nivolumab when compared with the previous standard of care in first-line metastatic/advanced clear cell renal cell carcinoma (RCC) (Escudier B, Tannir NM, McDermott DF, et al. CheckMate 214: efficacy and safety of nivolumab plus ipilimumab vs sunitinib for treatment-naïve advanced or metastatic renal cell carcinoma, including IMDC risk and PD-L1 expression subgroups. LBA5, ESMO 2017, 2017). These results change the frontline standard of care for this disease and have implications for the selection of subsequent therapies. For this reason the European Association of Urology RCC guidelines have been updated. PATIENT SUMMARY: The European Association of Urology guidelines will be updated based on the results of the phase III Checkmate-214 clinical trial. The trial showed superior survival for a combination of ipilimumab and nivolumab (IN), compared with the previous standard of care, in intermediate- and poor-risk patients with metastatic clear cell renal cell carcinoma. When IN is not safe or feasible, alternative agents such as sunitinib, pazopanib, and cabozantinib should be considered. Furthermore, at present, the data from the trial are immature in favourable-risk patients. Therefore, sunitinib or pazopanib remains the favoured agent for this subgroup of patients.

Department of Cancer Medicine Institut Gustave Roussy Villejuif France

Department of Clinical Sciences Lund Lund University Skåne University Hospital Lund Sweden

Department of Surgical and Perioperative Sciences Urology and Andrology Umeå University Umeå Sweden

Department of Urology Aberdeen Royal Infirmary Aberdeen UK; Academic Urology Unit University of Aberdeen Aberdeen UK

Department of Urology and Urologic Oncology Hannover Medical School Hannover Germany

Department of Urology Cabueñes Hospital Gijón Spain

Department of Urology Coimbra University Hospital Coimbra Portugal

Department of Urology Ludwig Maximilians University Munich Germany

Department of Urology Sunderby Hospital Sunderby Sweden

Department of Urology The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital Amsterdam The Netherlands

Department of Urology University Hospital Hamburg Eppendorf Hamburg Germany

Department of Urology University Hospital Schleswig Holstein Lübeck Germany

Department of Urology University of Rennes Rennes France

Division of Urology Maggiore Della Carità Hospital University of Eastern Piedmont Novara Italy

Faculty Hospital Plzeň and Faculty of Medicine in Plzeň Charles University Czech Republic

Patient Advocacy International Kidney Cancer Coalition Duivendrecht The Netherlands; University Medical Center Utrecht Department of Nephrology and Hypertension Regenerative Medicine Center Utrecht University of Utrecht The Netherlands

The Royal Free NHS Trust and Barts Cancer Institute Queen Mary University of London London UK

References provided by Crossref.org

Circulating Non-coding RNAs in Renal Cell Carcinoma-Pathogenesis and Potential Implications as Clinical Biomarkers

Current Concepts of Non-Coding RNAs in the Pathogenesis of Non-Clear Cell Renal Cell Carcinoma