Patients of metastatic kidney cancers on systemic therapy like targeted therapy (sunitinib/ Pazopanib/ Axitinib ) or immunotherapy ( Pembrolizumab / Nivolumab ) should continue the treatment if they are tolerating it well. They should see their doctor if they are having any adverse effects of the medicine.
Any palliative surgery ( nephrectomy )should be avoided whenever feasible.
There is an elevated risk of potential pulmonary (lung ) toxicities of immunotherapy drugs.
Poor-risk patients with poor performance status where the benefit of treatment is limited, the best supportive care alone could be considered and systemic therapy should be avoided.
Immune therapy regimes with a longer interval (4-weekly nivolumab or 6-weekly pembrolizumab) should be used where possible.
