Considerations in choosing IO/IO or IO/TKI in advanced RCC
| IO/IO | IO/TKI |
| Significant cardiovascular disease and/or poorly-controlled hypertension | Bulky, symptomatic disease |
| Sarcomatoid histology | Endocrine organ metastases |
| Significant proteinuria (eg, >2 g/24 hours) | Significant autoimmune conditions |
| Chronic wounds | Solid organ transplant |
| Anticipation of major or repeated surgical intervention/procedures | Baseline requirement for high-dose steroids |
| Patient preference to avoid potential chronic TKI toxicity | Patient unable or unwilling to accept potential for severe immune-mediated toxicity |
IO, immunotherapy; RCC, renal cell carcinoma; TKI, tyrosine kinase inhibitor.