Re: Laurence Albiges, Tom Powles, Michael Staehler, et al. Updated European Association of Urology Guidelines on Renal Cell Carcinoma: Immune Checkpoint Inhibition Is the New Backbone in First-line Treatment of Metastatic Clear-Cell Renal Cell Carcinoma. Eur Urol 2019;76:151-6 (European Urology)

We read with great interest the updated European Association of Urology (EAU) guidelines on renal cell carcinoma (RCC) described by Albiges et al [1]. According to the EAU guidelines, immune checkpoint inhibition (ICI) is recommended as the `backbone` of first-line treatment for patients with clear-cell metastatic RCC (mRCC), including patients with a favourable risk score according to the International Metastatic Renal Cell Carcinoma Database Consortium. For these patients, the recommended first-line treatment is the combination of pembrolizumab and axitinib, which consists of ICI (ie, PD-1 inhibition) and a tyrosine kinase inhibitor targeting VEGFR.