Nivolumab is a programmed death 1 (PD-1) inhibitor currently approved as 
second-line treatment for advanced renal cell carcinomas (RCC) after failure of 
standard antiangiogenic treatment. Motzer et al. have recently published in the 
New England Journal of Medicine the findings of CheckMate 214 trial, using 
nivolumab and ipilimumab, a cytotoxic T-lymphocyte antigen 4 (CTLA-4) inhibitor, 
versus sunitinib in previously untreated advanced RCC. The combination 
demonstrated a higher 18-month overall survival rate of 75% versus 60%, and a 
higher objective response rate of 42% versus 27%, for the combination in favor 
over sunitinib monotherapy. These results herald the rapidly changing role of 
immune checkpoint inhibitor therapy as first-line treatment for metastatic RCC.