Metastatic renal cell carcinoma (mRCC) is one of the most treatment-resistant malignancies to conventional cytotoxic chemotherapy. Previously, systemic treatment was limited to cytokine therapy [1]. Treatment options have expanded considerably for patients with mRCC with the greater understanding of the molecular mechanisms involved [2–4]. Seven molecular targeted agents for the treatment of mRCC are now approved, with significant improvements in progression-free survival (PFS) but rarely with an impact on overall survival (OS) [5].
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