5
Active surveillance
a
Cytoreductive nephrectomy
b
Intermediate or
poor risk disease
Combination treatment with two
immune checkpoint inhibitors
(i.e., ipilimumab and nivolumab) or
an immune checkpoint inhibitor in
combination with a vascular endothelial
growth factor receptor (VEGFR)
tyrosine kinase inhibitor (TKI)
Immune checkpoint inhibitor in
combination with a VEGFR TKI
Monotherapy with either a
VEGFR TKI or an immune checkpoint
inhibitor
Favorable risk disease
patients who require
systemic therapy
Favorable risk disease
with co-existing
medical problems that
preclude combination
treatment
First-line Treatment
