Table 3 ESMO 2014 treatment guidelines—recommended treatments based on risk stratification [40]
Setting | Treatment group | Standard | Option |
|---|---|---|---|
First line | Good or intermediate risk | Sutinib [I, A] Bevacizumab + IFN-α [I, A] Pazopanib [I, A] | High-dose IL-2 [III, C] Sorafenib [II, B] Bevacizumab + low-dose IFN-α [III, B] |
Poor risk | Temsirolimus [II, A] | Sutinib [II, B] Sorafenib [III, B] Pazopanib [III, B] | |
Second line | Post cytokines | Axitinib [I, A] Sorafenib [I, A] Pazopanib [II, A] | Sutinib [III, A] |
Post-TKI | Nivolumab [I, A] Cabozantinib [I, A] | Axitinib [II, B] Everolimus [II, A] Sorafenib [III, B] | |
Third line | Post-two VEGF-TKIs | Nivolumab [II, A] Cabozantinib [II, A] | Everolimus [II, B] |
Post TKI and mTOR | Sorafenib [I, B] Nivolumab [V, A] Cabozantinib [V, A] | Other TKI [IV, B] Rechallenge [IV, B] | |
Post TKI/nivolumab | Cabozantinib [V, A] | Axitinib [IV, C] Everolimus [IV, C] | |
Post TKI/cabozantinib | Nivolumab [V, A] | Axitinib [V, C] Everolimus [V, C] |