When is immunotherapy too much? The case of favorable-risk metastatic renal cell carcinoma

Critical Reviews in Oncology/Hematology 2026 Open access

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Authors: Sebastiano Buti, Betty Dalla Valle, Alessandro Acunzo, Pietro Tuttobene, Prisca Tamarozzi, Virginia Agnetti, Michele Maffezzoli, Giuseppe Luigi Banna, Domenico Corradi, Matteo Santoni
DOI: 10.1016/j.critrevonc.2026.105238
Cited by: 1
References: 40

Abstract

Combination therapies integrating immune checkpoint inhibitors (ICIs) with vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs), or dual ICI regimens, currently represent the standard of care for advanced clear cell renal cell carcinoma (ccRCC). However, in most favorable-risk patients according to the IMDC classification-particularly those with a low disease burden and without disease-related symptoms-first-line monotherapy with VEGFR-TKIs remains a valid option. This review summarizes the preclinical and clinical evidence supporting this approach, with the aim of guiding oncologists in personalizing therapy while minimizing overtreatment and toxicity.

Fields of Study & Subjects

Renal cell carcinoma treatment Cancer Immunotherapy and Biomarkers Immunotherapy and Immune Responses

Publication details

Journal / source
Critical Reviews in Oncology/Hematology
Publisher
Elsevier BV
Volume
221
Pages
105238–105238
Publication date
28 February 2026
Language
EN