Treatment of Stage IV and Recurrent Renal Cell Cancer

For information about the treatments listed below, see the Treatment Option Overview section.

First-line therapy may include the following:

• Ipilimumab plus nivolumab.
• Pembrolizumab plus axitinib.
• Pembrolizumab plus lenvatinib.
• Nivolumab plus cabozantinib.
• Surgery (radical nephrectomy).
• Surgery (nephrectomy) to reduce the size of the tumor in patients with certain favorable tumor types.
• Cabozanitnib.
• Avelumab plus axitinib.
• Sunitinib.
• Pazopanib.
• Sorafenib.
• Temsirolimus.
• Bevacizumab with or without interferon.
• Interferon.
• Interleukin-2.
• Palliative radiation therapy.

Second-line therapy may include the following:

• Nivolumab (for patients previously treated with sunitinib, pazopanib, sorafenib, and/or axitinib).
• Lenvatinib plus everolimus (for patients previously treated with sunitinib, pazopanib, cabozantinib, axitinib, or sorafenib).
• Cabozantinib (for patients previously treated with sunitinib, pazopanib, sorafenib, or axitinib).
• Axitinib.
• Everolimus (for patients previously treated with sunitinib and/or sorafenib).
• Sorafenib.
• Palliative radiation therapy.

Third-line and fourth-line therapies may include:

• Tivozanib for patients who have had at least two other types of systemic treatments.
• Any of the agents listed for first-line or second-line therapy.

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.