Serial ctDNA negativity or clearance was linked to improved PFS compared with persistent ctDNA positivity during treatment. New data shows patients with nccRCC may benefit from adjuvant therapy at a comparable rate as patients with ccRCC. In the final segment of this roundtable, the panelists discuss the potential of adjuvant treatments and systemic therapy. In the fourth part of this roundtable series, the panelists discuss the use of IO/IO and IO/TKI therapy in nccRCC. In the third segment of this roundtable series, the panelists compare systemic therapy with nephrectomy for nccRCC. In part 2, new trials in the nccRCC treatment landscape are reviewed, and the use of IO/TKI and PD-L1 are discussed. In the first segment of this roundtable series, the panelists discuss the management of papillary metastatic nccRCC. Drs. Karine Tawagi and Christopher Wallis review the SUNNIFORECAST and TiNivo-2 trials at the ESMO Congress 2024. The combination of ipilimumab/nivolumab may be a new standard in some subgroups of patients with metastatic nccRCC. Drs. Barata and Tawagi provide updates in nccRCC, including SAMETA, PAPMET2, SUNNIFORECAST, and updated NCCN guidelines. In anticipation of ESMO, Dr. Katy Beckermann previews various clinical trials and studies to be presented in kidney cancer. Patients either underwent 54 weeks of treatment with everolimus 10 mg per day or treatment with a matching placebo. The panel concludes with an overview of advancements and upcoming trials in the treatment of nccRCC. The panel weighs the progress and challenges of adjuvant pembro and addresses the toxicity profiles of IO/TKI regimens. The panel delves into the challenges and treatment approaches for various rare subtypes of nccRCC, including translocation. CEUS for the assessment of nccRCC can provide a more sensitive alternative to conventional ultrasound imaging. The panel highlights recent advancements in combination therapies for nccRCC, with a focus on KEYNOTE-B61 and cabo-nivo. The panel focuses on CN, oligometastatic disease treatment, and advancements in systemic therapies over the past few decades. The panel explores our understanding of nccRCC, including classification, molecular distinctions, and prognostic criteria. A recent study that sought to characterize rare kidney tumors has identified novel biomarkers in nccRCC subtypes.