Renal cell carcinoma: guideline history
3 dated versions from 2019 to 2023 listing 4 changes. Pick two versions to see what changed between them; the timeline below shows every version with the event it is anchored to.
- AddedAdvanced clear-cell, first lineNivolumab plus cabozantinib and pembrolizumab plus lenvatinib added as preferred first-line regimens.
- AddedAdjuvant, intermediate-high or high risk after nephrectomyPembrolizumab for one year, the first adjuvant immunotherapy in RCC.
- AddedAdvanced clear-cell, after immunotherapy and VEGFR TKIBelzutifan as a later-line option; also for VHL-associated tumours since 2021.
Timeline
Anchored to: FDA approvals of nivolumab plus ipilimumab (April 2018, CheckMate 214) and pembrolizumab plus axitinib (April 2019, KEYNOTE-426)
- recategorisedAdvanced clear-cell, first line: Immunotherapy combinations replace sunitinib and pazopanib as the preferred first-line therapy.VEGFR TKI monotherapy preferred → nivolumab-ipilimumab (intermediate/poor risk) and pembrolizumab-axitinib preferred (category 1)
Anchored to: FDA approvals of nivolumab plus cabozantinib (January 2021, CheckMate 9ER), pembrolizumab plus lenvatinib (August 2021, CLEAR) and adjuvant pembrolizumab (November 2021, KEYNOTE-564)
- addedAdvanced clear-cell, first line: Nivolumab plus cabozantinib and pembrolizumab plus lenvatinib added as preferred first-line regimens.
- addedAdjuvant, intermediate-high or high risk after nephrectomy: Pembrolizumab for one year, the first adjuvant immunotherapy in RCC.
Anchored to: FDA approval of belzutifan after immunotherapy and VEGF-TKI, December 2023 (LITESPARK-005)
- addedAdvanced clear-cell, after immunotherapy and VEGFR TKI: Belzutifan as a later-line option; also for VHL-associated tumours since 2021.
Where the bodies stand today
| Setting and intervention | NCCN | ESMO | NICE | ASCO | Verdict |
|---|---|---|---|---|---|
Renal cell carcinoma · Untreated advanced clear-cell, intermediate or poor risk Nivolumab plus ipilimumab (CheckMate 214) | Preferred Category 1, preferred 2018-04 | Recommended I, A; ESMO-MCBS 4 2021 | Recommended TA780 2022-04 | Recommended 2022 | Bodies agree |
Renal cell carcinoma · Untreated advanced clear-cell, any risk Pembrolizumab plus axitinib (KEYNOTE-426) | Preferred Category 1, preferred 2019-04 | Recommended I, A; ESMO-MCBS 4 2021 | Recommended TA650 2020-09 | Recommended 2022 | Bodies agree |
Other cancers
Each entry is anchored to a dated public event and links to the guideline body’s page for the disease; NCCN “Summary of changes” pages sit behind a free login and are not reproduced. Version labels say “update” where the NCCN version number has not been verified. Corrections are welcome via the repository.