(UroToday.com) The virtual EAU 2020 meeting featured a thematic session discussing immunotherapy combinations for intermediate-poor risk metastatic renal cell carcinoma (mRCC). Axel Merseburger, MD, PhD, discussed the utility of combining Immuno-Oncology (IO) treatment with TKIs. Dr. Merseburger notes that according to older versions of the EAU guidelines, the first-line treatment for IMDC intermediate-poor risk patients is ipilimumab plus nivolumab. Additional options (without a strong recommendation) are cabozantinib, sunitinib or pazopanib. In an update of these guidelines (with new data reported recently), the current recommendations for intermediate-poor risk patients is pembrolizumab plus axitinib or ipilimumab plus nivolumab.1 Currently, Dr. Merseburger notes that we have new first-line combination treatments with phase 3 data, including nivolumab plus ipilimumab, axitinib plus pembrolizumab, and axitinib plus avelumab.