An Update on Predictive Biomarkers in Metastatic Renal Cell Carcinoma. 
One of the major challenges of personalized oncology lies in identifying predictive biomarkers of response to therapy that are practical in the clinical setting.  Although many new targeted and immune-based treatments have emerged in recent years as effective systemic therapy options in metastatic renal cell carcinoma (mRCC), optimizing the selection and sequencing of treatments for any individual patient with this disease remains a significant challenge.  The CheckMate-214 trial demonstrated that the International mRCC Database Consortium risk model is an effective predictive biomarker in the first-line treatment of mRCC.  To date this remains the only prospectively validated predictive biomarker in mRCC.  A number of other promising biomarker candidates are under active investigation but require prospective validation before widespread clinical adoption.  PATIENT SUMMARY: The International Metastatic Renal Cell Carcinoma Database Consortium risk model is currently the only validated tool that can help clinicians in determining which patients should receive sunitinib versus a combination of nivolumab and ipilimumab as a first treatment for metastatic renal cell carcinoma.  Other tools are being actively investigated.