Sequencing and Combination of Systemic Therapy in Metastatic Renal Cell Carcinoma  Guillermo de Velasco, Axel Bex, Laurence Albiges, Thomas Powles, Brian I. Rini, Robert J. Motzer, Daniel Y.C. Heng, Bernard Escudier  European Urology Oncology  Volume 2, Issue 5, Pages 505-514 (September 2019) DOI: 10.1016/j.euo.2019.06.022 Copyright © 2019 Terms and Conditions

Fig. 1 Emerging potential sequential treatments after first-line VEGF-TT. CTLA-4=cytotoxic T-lymphocyte-associated antigen 4; mTOR=mammalian target of rapamycin; PD-1=Programmed Cell Death protein 1; TKI=tyrosine kinase inhibitor; VEGF-TT=vascular endothelial growth factor-targeted therapy. European Urology Oncology 2019 2, 505-514DOI: (10.1016/j.euo.2019.06.022) Copyright © 2019 Terms and Conditions

Fig. 2 Level of evidence after TKIs (nivolumab and cabozantinib have the highest level of evidence). OS=overall survival; PFS=progression-free survival; TKI=tyrosine kinase inhibitor. ** Combination of lenvatinib and everolimus has shown OS in a small phase 2 randomized clinical trial powered to study PFS. European Urology Oncology 2019 2, 505-514DOI: (10.1016/j.euo.2019.06.022) Copyright © 2019 Terms and Conditions

Fig. 3 Panel of options for the second and third lines after ipilimumab-nivolumab. Eve=everolimus. ** Tivozanib could also be an option for the third and fourth lines, but data are still unpublished. European Urology Oncology 2019 2, 505-514DOI: (10.1016/j.euo.2019.06.022) Copyright © 2019 Terms and Conditions