Front-Line Therapy for Metastatic Renal Cell Carcinoma: A Perspective on the Current Algorithm and Future Directions

SIMPLE SUMMARY: The treatment landscape of metastatic renal cell carcinoma has changed dramatically over the course of the last decade. The use of doublet immunotherapy or targeted therapy/immunotherapy regimens has become the standard of care. Herein, we outline the important elements and considerations in the treatment of renal cell carcinoma and explore prospective treatment options within this setting. ABSTRACT: Over the last decade, the treatment paradigm of metastatic renal cell carcinoma has rapidly evolved, with notable changes in the front-line setting. Combination therapies involving the use of either doublet therapy with immune checkpoint inhibitors or combination VEGFR-directed therapies with immune checkpoint inhibitors have significantly improved clinical outcomes, including prolonged overall survival and durable response to treatment. We aim to highlight the Food and Drug Administration-approved front-line therapy options, the navigation of treatment selection, and the future directions of metastatic renal cell carcinoma therapies.