More than 4 years of progression-free survival in a patient with metastatic renal cell carcinoma treated sequentially with sunitinib, everolimus, sorafenib, and temsirolimus.

Until recently, immunotherapy has been the standard of care for patients with nonresectable metastatic renal cell carcinoma (mRCC); however, immunotherapy is associated with a low response rate and significant toxicity. Because of their demonstrated ability to prolong progression-free survival, agents targeting vascular endothelial growth factor receptors or the mammalian target of rapamycin now have become standard therapies for patients with mRCC. Attaining lasting clinical benefits, however, requires multiple lines of therapy. This case study reports the case of a 52-year-old man with mRCC who remained free of disease progression for 48 months while receiving sequential therapy of sunitinib, everolimus, sorafenib, and temsirolimus.