Renal cell carcinoma
A malignant epithelial tumor arising from the proximal nephron tubules. Clear cell subtype accounts for 70–80%. Localized stage I–III is treated surgically (partial or radical nephrectomy). For metastatic stage IV, ESMO 2024 base therapy is tyrosine kinase inhibitors (sunitinib, pazopanib, cabozantinib), mTOR inhibitors (everolimus, temsirolimus), and immunotherapy (nivolumab + ipilimumab, pembrolizumab + lenvatinib, pembrolizumab + axitinib).
ICD-10 C642 drugs
Also known as: Hypernephroma, Kidney adenocarcinoma, RCC
Drugs used for this condition
- AEverolimusSecond line · mTOR kinase inhibitor – immunosuppressant and antineoplasticSecond-line for metastatic clear cell RCC after VEGF inhibitor progression (sunitinib, pazopanib) per ESMO 2024. Dose 10 mg once daily. RECORD-1 extended progression-free survival from 1.9 to 4.9 months.
- ASunitinibFirst line · Multi-target tyrosine kinase inhibitor – VEGFR, PDGFR, c-KIT, FLT3, RETAdvanced and/or metastatic renal cell carcinoma in adults. Per ESMO 2024 and SEOM 2023, in favorable or intermediate IMDC risk, sunitinib remains an option in first-line, especially when immunotherapy combinations are unavailable or contraindicated. Dose: 50 mg orally once daily for 4 weeks followed by 2 weeks off (4/2 schedule). About 47% partial or complete responses; median PFS 11 months.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit