Improvements in overall survival (OS) among patients with metastatic renal cell carcinoma (mRCC) have been achieved by combination therapy approaches using agents targeting immune checkpoint blockade (ICB) and the vascular endothelial growth factor (VEGF) receptor.¹ Patients and physicians have numerous first-line immuno-oncology (IO) treatment options, including doublet ICB therapy with ipilimumab-nivolumab (IOIO) or ICB therapy with VEGF receptor inhibitor (IOVE; including axitinib-avelumab, axitinib-pembrolizumab, cabozantinib-nivolumab, and lenvatinib-pembrolizumab) combination therapies. However, most patients eventually develop resistance to these therapies.²

A United Kingdom–wide appreciation of the systemic failings of emergency cancer care led to the creation of a new subspecialty, acute oncology. It was meant to bridge the gap between admitting teams, oncology, and palliative care, providing support to manage the symptoms of cancer, the side effects of cancer treatment, and people presenting with cancer of unknown primary origin. This article identifies the reasons for the creation of acute oncology and explores various models for this aspect of cancer care worldwide. With health care budgets static and demand increasing, the article also identifies ways in which acute oncology can contribute to an efficient and caring health system.