Dual immune checkpoint inhibition in metastatic renal cell carcinoma

The introduction of dual immune checkpoint inhibition with nivolumab and ipilimumab (nivo–ipi) represents a paradigm change in the first-line treatment of metastatic renal cell carcinoma (mRCC). As the first upfront treatment to demonstrate a significant improvement in overall survival (OS) when compared with sunitinib (sun), the previous standard of care, the immune combination was also shown to achieve unprecedented rates of complete remission. Benefits were seen in the intent-to-treat (ITT) and intermediate-poor (IP) risk patient populations, regardless of PD-L1 expression.