Table 2.

Options for patients with advanced metastatic sarcomatoid or poorly differentiated RCC

Participation in clinical trials is strongly encouraged

Therapy	Rationale
Ipilimumab + Nivolumab80 (preferred)	Based on subgroup analysis of sarcomatoid RCC patients in CheckMate 214 showing a complete response rate of 18% and a mOS of 31 months compared to sunitinib (CR 0% and mOS 13.6)
Axitinib + Pembrolizumab81 (preferred)	Based on subgroup analysis of sarcomatoid RCC patients in KEYNOTE 426 showing a complete response rate of 12% and improved mOS (not reached) compared to sunitinib (CR 0%)
Nivolumab + cabozantinib82 (preferred)	Based on subgroup analysis of sarcomatoid RCC in Checkmate 9ER showing improved PFS (10.9 m and mOS not reached compared to sunitinib (PFS 4.2 and mOS 19.7 m)
Sunitinib	Based on prospective, non-randomized data from the Expanded Access Program

CR: complete response; mOS: median overall survival; PFS: progression-free survival; RCC: renal cell carcinoma.