Clinical treatment decisions for advanced renal cell cancer.

Seven targeted agents have improved the prognosis of advanced renal cell carcinoma (RCC), but none are effective in the post-nephrectomy adjuvant setting. Among the available first-line options for advanced RCC, sunitinib remains the most commonly used first-line therapy, but several studies suggest pazopanib may be better tolerated. Increasingly, choice of therapy may be driven by toxicity profiles. Cytoreductive nephrectomy remains important, even in the era of targeted therapies in selected patients.