Table 14 Drug treatment strategies for metastatic or unresectable clear cell type renal cell carcinoma

(recommended for first choice of clinical studies in any of the following situations)

Pabrolizumab + lenvatinib

Pezopanib

High risk

Pabrolizumab + lenvatinib

Backline therapy

Treatment status Stratification Tier I specialist recommendations Tier II specialist recommendations III expert recommendations
First-line treatment Medium to low risk Pabrolizumab + axitinib Avelumab + axitinib Axitinib
Cabozantinib high-dose interleukin-2
Navulizumab + Cabozantinib Nabritumomab + Epirimumab
Sunitinib
Pabrolizumab + axitinib Avelumab + axitinib Axitinib
Pezopanib high-dose interleukin-2
Navulizumab + Cabozantinib Sunitinib Texilomox
Nabritumomab + Epirimumab
Cabozantinib
Carbetinib Axitinib Bevacizumab
Navulizumab Lenvatinib+Evimox Sorafenib
Navulizumab + Ipilimumab Pabrolizumab + axitinib high-dose interleukin-2
Everolimus Texilomox
Pezopanib
Sunitinib
Tivozanib
Avelumab + axitinib