BACKGROUND: The 2021 American Society of Clinical Oncology (ASCO) Genitourinary 
Cancers Symposium represents an unmissable event for oncologists who deal with 
renal cell carcinoma (RCC).
AIM AND RESULTS: This article describes the main acquisitions of RCC management, 
including the advent of a new combo (pembrolizumab+lenvatinib) as first-line 
therapy, the confirmation of an OS advantage of ICI plus VEGFR-TKI combinations 
over sunitinib at longer follow-up, the persistent benefit from these 
combinations in particular subgroups (clear cell mRCC tumors with sarcomatoid 
differentiation), and possible new approaches in subsequent lines of therapy 
(including the HIF-2α inhibitor belzutifan).
CONCLUSIONS: This 2021 ASCO Genitourinary Cancer Symposium laid the foundations 
for further knowledge development necessary for an increasingly personalized 
management of mRCC.