Selecting Cabozantinib After First-Line Therapy in Advanced Renal Cell Carcinoma

In this segment on advanced renal cell carcinoma, Dr. Geynisman focuses on the clinical scenarios in which cabozantinib is selected following progression on first-line therapy. Dr. McGregor and Dr. Wulff discuss how cabozantinib remains a commonly used option due to its activity across multiple lines and its established role in NCCN recommendations. The panel highlights that cabozantinib is often favored in patients who have progressed on IO-based combinations, particularly when a VEGFR TKI is needed as the next line of therapy. They also note its utility in patients with more aggressive disease features, including those with bone metastases or higher disease burden. Tolerability, prior toxicity, and patient comorbidities are also considered when selecting this agent. The discussion reinforces that cabozantinib continues to be a versatile and reliable option in the treatment continuum for advanced renal cell carcinoma.