In recent years, an improved understanding of renal cell carcinoma (RCC) tumor biology has translated into major advancements in the treatment of patients with metastatic RCC. These novel therapies include inhibitors of the vascular endothelial growth factor (VEGF) pathway and inhibitors of the mammalian target of rapamycin (mTOR) pathway. While immunotherapy was once the standard of care, this progress has prompted a reassessment of the role of immunotherapy for metastatic RCC. However, recent insights into how the immune response to a tumor is regulated may allow patients to obtain a durable response to immunotherapy without the significant toxicity associated with conventional approaches.
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