Practical Insights and Challenges in the Rational Use of Targeted Agents in Metastatic Clear Cell Renal Carcinoma

Renal cell carcinoma (RCC) accounts for approximately 4% of all primary cancers diagnosed in the United States with an estimated 13,000 deaths in 2010. Metastatic disease is the initial presentation in approximately 30% of the patients. Until 2006, immunotherapy with Interferon-? and Interleukin-2 represented the primary treatment of advanced RCC but better understanding of the pathogenesis and molecular biology of RCC paved the way for targeted molecular therapies. Six molecular targeted agents have been approved for the treatment of metastatic renal cell carcinoma (mRCC). This review summarizes the approved targeted agents, their toxicities and practical insights into the treatment of mRCC.