Management and systemic treatment of clear cell metastatic renal cell carcinoma: BSMO expert panel recommendations

Almost 30% of patients with renal cell cancer present initially with advanced stage IV disease. In the past decade, the management of the metastatic renal cell cancer has been revolutionised by the knowledge of its molecular biology and development of targets against vascular endothelial growth factor and mammalian target of rapamycin pathways. In this paper we present recommendations based on a thorough review of available guidelines and data from the phase III randomised controlled trials that evaluated new agents in patients with advanced metastatic renal cancer.