Recent randomised trials have demonstrated a survival benefit for a front-line ipilimumab and nivolumab combination therapy, and pembrolizumab and axitinib combination therapy in metastatic clear-cell renal cell carcinoma. The European Association of Urology Guidelines Panel has updated its recommendations based on these studies. PATIENT SUMMARY: Pembrolizumab plus axitinib is a new standard of care for patients diagnosed with kidney cancer spread outside the kidney and who did not receive any prior treatment for their cancer (treatment naïve). This applies to all risk groups as determined by the International Metastatic Renal Cell Carcinoma Database Consortium criteria.

Department of Cancer Medicine Gustave Roussy Université Paris Saclay Villejuif France

Department of Clinical Sciences Lund Lund University Skåne University Hospital Malmö 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 Chaim Sheba Medical Center Tel Hashomer Ramat Gan Israel

Department of Urology Coimbra University Hospital Coimbra Portugal

Department of Urology Elbe Kliniken Stade Stade Germany

Department of Urology Ludwig Maximilians University Munich Germany

Department of Urology Royal Free Hospital Pond Street London UK

Department of Urology Sunderby Hospital Sunderby Sweden

Department of Urology The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital Amsterdam The Netherlands; Specialist Centre for Kidney Cancer Royal Free London NHS Foundation Trust London UK; UCL Division of Surgery and Interventional Science London UK

Department of Urology University Hospital Plzeň Plzeň Czech Republic; Faculty of Medicine in Plzeň Charles University Plzeň Czech Republic

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

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

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

Eur Urol. 2020 Mar;77(3):e76-e77. doi: 10.1016/j.eururo.2019.09.030. PubMed

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