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Opinion|Videos|April 13, 2026

Managing Tolerability and Dose Optimization in Advanced Renal Cell Carcinoma

Author(s)Moshe Ornstein, MD, MA, Adam Singer, MD, Terence W. Friedlander, MD

In this segment on advanced renal cell carcinoma, Dr. Ornstein emphasizes that treatment is only effective if patients are able to remain on therapy, framing dose management as a critical component of clinical care. He asks how clinicians approach dosing and tolerability, particularly with VEGF receptor targeted therapy–based combinations.

Episodes in this series

Experts featured in this series.

EP. 1 First-Line Treatment Selection in Advanced Renal Cell Carcinoma

Experts featured in this series.

EP. 2 Frontline Regimen Selection in Advanced Renal Cell Carcinoma

Experts featured in this series.

EP. 3 Impact of Sequencing on First-Line Decisions in Advanced Renal Cell Carcinoma

Experts featured in this series.

EP. 4 Real-World Treatment Attrition in Advanced Renal Cell Carcinoma

Experts featured in this series.

EP. 5 Managing Tolerability and Dose Optimization in Advanced Renal Cell Carcinoma

Experts featured in this series.

EP. 6 Second-Line Treatment Decision-Making in Advanced Renal Cell Carcinoma

In this segment on advanced renal cell carcinoma, Dr. Ornstein emphasizes that treatment is only effective if patients are able to remain on therapy, framing dose management as a critical component of clinical care. He asks how clinicians approach dosing and tolerability, particularly with VEGF receptor targeted therapy–based combinations.

Dr. Singer discusses his real-world approach, noting that most patients will require some degree of dose modification over the course of treatment. He emphasizes that starting at standard doses is common, but early recognition of adverse events and timely dose adjustments are essential to maintain therapy. Rather than viewing dose reductions as a limitation, he describes them as a practical strategy to help patients stay on treatment longer. The discussion highlights that individualized dosing, close monitoring, and proactive management are key to balancing efficacy and tolerability, ultimately supporting sustained clinical benefit in advanced renal cell carcinoma.

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