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. 2020 Jun 3;17(8):425–427. doi: 10.1038/s41585-020-0345-5

Fig. 1. Proposed management algorithm for advanced renal cell carcinoma during COVID-19.

Fig. 1

Our personal recommendations during the coronavirus disease 2019 (COVID-19) pandemic on the management of patients with locally advanced, metastatic and oligometastatic renal cell carcinoma (RCC). VEGF TKI, vascular endothelial growth factor tyrosine kinase inhibitor. aPatients with a history of an active autoimmune condition, with a previous life-threatening autoimmune condition, receiving chronic immunosuppressive medication or with other high-risk features of developing immune-related adverse events (irAEs). bIn patients with an intermediate risk of developing irAEs, such as patients with psoriasis, coeliac disease or type 1 diabetes mellitus, consider upfront axitinib monotherapy followed by addition of pembrolizumab when COVID-19 risk subsides. cFavourable features in the oligometastatic setting include >12-month disease-free interval after nephrectomy, low-grade tumour, good performance status and lung-only metastasis.