title: Current Management Strategy for Metastatic Renal Cell Carcinoma and Future Directions.
abstract: OBJECTIVE
  Major strides have been made in the treatment of kidney cancer in the last several years with checkpoint immunotherapies and novel targeted agents. This manuscript will review current treatment strategies for metastatic renal cell carcinoma and will discuss future directions.
  
  
  RESULTS
  Most recently, several new drugs including nivolumab, cabozantinib, and a combination of lenvatinib and everolimus have demonstrated acceptable toxicity and significantly improved overall survival, but evidence-based guidelines for sequencing of the approved treatment options and treatment selection based on biomarkers are still missing. Despite the significant progress, many questions still remain unanswered. Several ongoing clinical trials are evaluating sequencing, timing of cytoreductive nephrectomy, combinations of immunotherapies and targeted therapies as well as selection of the best systemic treatment. Personalized treatment based on tumor profiling is one of the brightest spots on the horizon.
authors.affiliation: Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA.
authors.forename: Hussein
authors.initials: H
authors.lastname: Merza
authors.affiliation: National Cancer Institute, Center for Cancer Research, Building 10, Room B2L324B, Bethesda, MD, 20892, USA. marijo.bilusic@nih.gov.
authors.forename: Marijo
authors.initials: M
authors.lastname: Bilusic
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy*; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D007680:Kidney Neoplasms / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents
keywords: Immunotherapy; Kidney cancer; Targeted therapy; Tyrosine kinase inhibitors