(UroToday.com) The treatment landscape for first-line therapy among patients with metastatic renal cell carcinoma (mRCC) has changed dramatically over the past 2 years. In 2018, the publication of the CheckMate214 data demonstrated a survival benefit for patients treated with nivolumab and ipilimumab compared with sunitinib in intermediate and poor-risk mRCC, ushering in the immunotherapy era for mRCC. The subsequent publication of the JAVELIN Renal 101, KEYNOTE-426, and CheckMate-9ER studies demonstrated the superiority of avelumab and axitinib, pembrolizumab, and axitinib, and nivolumab and cabozantinib compared to sunitinib in this disease space. CheckMate214 opened the checkpoint inhibitor era in first-line therapy for metastatic renal cell carcinoma. Ongoing follow-up of this trial has demonstrated the durable superiority of the combined immunotherapy approach. In a plenary abstract presentation in the Poster Highlights Session: Renal Cell Cancer – Clinical Trial Updates session at the 2021 ASCO GU Cancers Symposium, Dr. Nizar Tannir present an exploratory analysis aimed at characterizing patterns of progression among patients treated with nivolumab and ipilimumab, as compared to sunitinib, with 4 years minimum follow-up.