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Immunotherapy is good choice. However, considering the Good PS and CCRCC pathology would also consider Cabozantinib per Toni choueiri et al NEJM article.
Given the good PS and the extent of disease. Considering SBRT and debunking recurrent disease then consider further treatment. Also the updated results from expanded cohorts in CheckMate 016 confirmed initial safety findings and promising anti tumor activity for nivolumab + ipilimumab in patients with metastatic renal cell carcinoma. Overall survival for the combination in metastatic renal cell carcinoma is encouraging.
Another option is retreatment with the best tki used previously
Pending Moderator approval.
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