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1. JM is a 60-year-old male who is recovering from nephrectomy surgery. He was diagnosed with local regional, high-risk, clear cell renal cell carcinoma. He presents to the clinic today to discuss his treatment options. His labs are normal and he is in good physical condition. He states that he is willing to undergo treatment but asks if any treatment will benefit him. What is the best response to JM?

A. Treatment with atezolizumab will improve your chances of being alive at 5 years B. Cabozantinib will increase your chances of being alive at 5 years C. Sunitinib will improve your chances of being alive and disease free at 5 years D. Avelumab plus axitinib will improve your chances of being alive and disease free at 5 years E. Unsure

2. VAP is a 65-year-old male with metastatic renal cell carcinoma. According to the results of a nephrectomy, the cancer is a clear cell histology, and his labs indicate that he is in the intermediate-risk group (low hemoglobin and high lactate dehydrogenase). The oncologist discussed several first-line treatment options with VAP, but he wants to get your opinion as the oncology pharmacist. Which of the following should you tell VAP?

A. Sunitinib is the superior agent for patients in the intermediate-risk category B. Pembrolizumab monotherapy is superior to axitinib monotherapy C. Cabozantinib plus atezolizumab is superior to cabozantinib monotherapy D. Nivolumab plus ipilimumab is superior to sunitinib monotherapy E. Unsure

3. CBD is a 48-year-old male with metastatic renal cell carcinoma (mRCC) that has spread to both lungs and his pelvis. He asks your opinion about his treatment plan. He believes he is going to undergo surgery to remove the kidney and that he will be cured as a result of the surgery. He wants to know why he needs both immunotherapy and surgery. Which of the following is the best response?

A. Surgery is the most effective treatment modality; immunotherapy will treat any microscopic disease that is left and decrease the risk of recurrence B. Immunotherapy is the most effective treatment modality; surgical removal of the kidney may augment the immunotherapy and, while it is commonly performed, is optional C. Either of the treatments is curative, but only 1 should be used D. Prospective trials have shown that the combination of surgery and immunotherapy is the best way to cure mRCC E. Unsure

4. BDK is a 53-year-old male with renal cell carcinoma who has been on avelumab plus axitinib (on trial) for the past 2 years. Now, his disease has progressed. When considering second-line therapy options, which of the following statements is true?

A. Cytotoxic chemotherapy is the best proven therapy for patients who have failed vascular endothelial growth factor inhibition and immunotherapy B. Nivolumab plus ipilimumab has been shown to be effective salvage therapy, even for patients who have had prior immunotherapy C. Treatment withdrawal will result in an approximately 20% response rate, making it the next best step D. There is no effective treatment option remaining E. Unsure

5. The team in the genitourinary clinic discusses the new data that was just published regarding combination immunotherapy for metastatic renal cell carcinoma. In this context, which of the following statements is true?

A. An immune checkpoint inhibitor plus an anti-vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor (TKI) is superior to anti-VEGF-TKI monotherapy B. An immune checkpoint inhibitor plus an anti-VEGF-TKI is superior to an immune checkpoint inhibitor as monotherapy C. Combination immune checkpoint inhibition (nivolumab plus ipilimumab) is superior to an immune checkpoint inhibitor plus an anti-VEGF-TKI (pembrolizumab plus axitinib) D. Combination immune checkpoint inhibition (nivolumab plus ipilimumab) is inferior to an immune checkpoint inhibitor plus an anti-VEGF-TKI (pembrolizumab plus axitinib) E. Unsure

Evaluation Questions

6. How confident are you in your decision about treatment for BDK in question 4 above?

A. Not at all confident B. Somewhat confident C. Confident D. Highly confident

Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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4. BDK is a 53-year-old male with renal cell carcinoma who has been on avelumab plus axitinib (on trial) for the past 2 years. Now, his disease has progressed. When considering second-line therapy options, which of the following statements is true?

5. The team in the genitourinary clinic discusses the new data that was just published regarding combination immunotherapy for metastatic renal cell carcinoma. In this context, which of the following statements is true?

Evaluation Questions

6. How confident are you in your decision about treatment for BDK in question 4 above?

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Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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4. BDK is a 53-year-old male with renal cell carcinoma who has been on avelumab plus axitinib (on trial) for the past 2 years. Now, his disease has progressed. When considering second-line therapy options, which of the following statements is true?

5. The team in the genitourinary clinic discusses the new data that was just published regarding combination immunotherapy for metastatic renal cell carcinoma. In this context, which of the following statements is true?

Evaluation Questions

6. How confident are you in your decision about treatment for BDK in question 4 above?

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