(UroToday.com) There have been transformational changes in first-line therapy for patients with advanced renal cell carcinoma (RCC) in the past three years. Foremost among these is the move from monotherapy to combination approaches. While CheckMate 214 first brought combination therapy with dual checkpoint inhibition to the forefront, subsequent studies have examined combinations of immune checkpoint inhibitors and tyrosine-kinase inhibitors in the first-line setting. One such study was the phase 3 JAVELIN Renal 101 trial (NCT02684006), which demonstrated improvements in progression-free survival and increased objective response rates for patients treated with avelumab and axitinib compared to sunitinib. In the Kidney and Bladder Poster session at the American Society of Clinical Oncology (ASCO) 2021 Annual Meeting, Dr. Choueiri presented a secondary analysis of this trial aimed at identifying blood-based biomarkers with differential responses to treatment.