Modern Therapeutic Approaches in Metastatic Renal Cell Carcinoma

Renal cell carcinoma (RCC) is the most deadly urological malignancy with only 62% of all patients surviving 5 years in all stages. Approximately 20–30% present initially with metastatic disease as well as 20–40% of patients who will develop systemic spread after surgery. New insights in angiogenesis lead to the development of new drugs directed against receptors and downstream signaling molecules of angiogenetic regulation mechanisms. The results of clinical trials with these drugs will lead to a change of paradigm in the systemic treatment of RCC patients. Specially Sutent, Sorafenib and Temsirolimus proved efficacy in metastatic disease and should be added substantially to the therapeutic armamentarium when surgery of the primary or metastases is impossible.