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VEGF inhibitors and immunotherapies have changed the landscape of advanced renal cell carcinoma (RCC) treatment. So would it be crazy to try them together? An international phase 1 trial reported this week that avelumab (anti-PD-L1) + axitinib (anti-VEGF-R) is safe (enough) to move forward with a phase 3 component comparing this combo to the longtime standard sunitinib. The most common at least grade 3 toxicity was hypertension, occurring in 29%. The only treatment related death? Yep, myocarditis.