Clearing up Clear Cell: Clarifying the Immuno-Oncology Treatment Landscape for Metastatic Clear Cell RCC

SIMPLE SUMMARY: Renal cell carcinoma (RCC) is the most common cancer of the kidney. Historically, patients with disease extending beyond the kidney had poor oncologic outcomes. However, discovery of the underlying causes of RCC and the creation of therapeutic agents to target these pathways has revolutionized the management of metastatic RCC. Application of these agents alone or in combination with surgery continue to show encouraging results. In this review, we explore the clinical trial landscape of metastatic RCC, specifically the clear cell type, with particular emphasis on current and upcoming trials utilizing immunotherapeutic agents. ABSTRACT: Patients with advanced or malignant renal cell carcinoma at the time of diagnosis have historically had a poor prognosis. Immunonologic agents have significantly altered the therapeutic landscape and clinical outcomes of these patients. In this review, we highlight recent and upcoming clinical trials investigating the role of immunotherapies in clear cell RCC. In particular, we emphasize immunotherapy-based combinations, including immune checkpoint inhibitor (ICI) combinations, neoadjuvant, and adjuvant ICI, and ICI agents combined with anti-VEGF therapy.