The randomised phase III clinical trial Checkmate-214 showed a survival superiority for the combination of ipilimumab and nivolumab when compared with the previous standard of care in first-line metastatic/advanced clear cell renal cell carcinoma (RCC) (Escudier B, Tannir NM, McDermott DF, et al. CheckMate 214: efficacy and safety of nivolumab plus ipilimumab vs sunitinib for treatment-naïve advanced or metastatic renal cell carcinoma, including IMDC risk and PD-L1 expression subgroups. LBA5, ESMO 2017, 2017). These results change the frontline standard of care for this disease and have implications for the selection of subsequent therapies. For this reason the European Association of Urology RCC guidelines have been updated. PATIENT SUMMARY: The European Association of Urology guidelines will be updated based on the results of the phase III Checkmate-214 clinical trial. The trial showed superior survival for a combination of ipilimumab and nivolumab (IN), compared with the previous standard of care, in intermediate- and poor-risk patients with metastatic clear cell renal cell carcinoma. When IN is not safe or feasible, alternative agents such as sunitinib, pazopanib, and cabozantinib should be considered. Furthermore, at present, the data from the trial are immature in favourable-risk patients. Therefore, sunitinib or pazopanib remains the favoured agent for this subgroup of patients.

中文翻译：

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欧洲泌尿外科协会最新指南：治疗一线转移性透明细胞肾癌的建议。

III期随机临床试验Checkmate-214与一线转移性/晚期透明细胞肾细胞癌（RCC）的既往治疗标准相比，依匹莫单抗和nivolumab联合治疗具有生存优势（Escudier B，Tannir NM， McDermott DF等人的CheckMate 214：尼古鲁单抗联合依匹莫单抗与舒尼替尼治疗未治疗的晚期或转移性肾细胞癌的疗效和安全性，包括IMDC风险和PD-L1表达亚组.LBA5，ESMO 2017，2017）。这些结果改变了对这种疾病的一线治疗标准，并对后续治疗的选择产生了影响。因此，欧洲泌尿外科协会RCC指南已更新。病人总结：欧洲泌尿外科协会指南将根据III期Checkmate-214临床试验的结果进行更新。该试验显示，与以往的护理标准相比，ipilimumab和nivolumab（IN）的组合在转移性透明细胞肾细胞癌的中危和低危患者中具有更高的生存率。当IN不安全或不可行时，应考虑使用舒尼替尼，帕唑帕尼和卡博替尼等替代药物。此外，目前，该试验的数据在高危人群中尚不成熟。因此，舒尼替尼或帕唑帕尼仍然是该亚组患者的首选药物。在转移性透明细胞肾细胞癌的中危和低危患者中。当IN不安全或不可行时，应考虑使用舒尼替尼，帕唑帕尼和卡博替尼等替代药物。此外，目前，该试验的数据在高危人群中尚不成熟。因此，舒尼替尼或帕唑帕尼仍然是该亚组患者的首选药物。在转移性透明细胞肾细胞癌的中危和低危患者中。当IN不安全或不可行时，应考虑使用舒尼替尼，帕唑帕尼和卡博替尼等替代药物。此外，目前，该试验的数据在高危人群中尚不成熟。因此，舒尼替尼或帕唑帕尼仍然是该亚组患者的首选药物。