Sequential targeted therapy with vascular endothelial growth factor inhibitors and mammalian target of rapamycin inhibitors remains the standard for metastatic renal cell carcinoma. Nivolumab is the first checkpoint inhibitor registered for metastatic renal carcinoma and many clinical studies with immunotherapy agents and combinations are running.
Despite some positive signals from randomised trials, adjuvant targeted therapy still cannot be considered standard for high risk completely resected renal carcinoma and updates of trials with longer follow-up are awaited.