Targeted therapies for kidney cancer in urologic practice.

Renal cell carcinoma (RCC) is the most lethal of all genitourinary malignancies with nearly half of all patients presenting with locally advanced or metastatic disease. Systemic treatments such as chemo- or immunotherapy have historically been associated with overall response rates of 5-15% with very few durable responses. The basis of newly approved, more effective targeted therapies for metastatic RCC are based on a fundamental knowledge of the molecular mechanisms that give rise to RCC. We review the clinical data for targeted therapies in RCC and discuss the pertinent biology, side effects, and targets important to the practicing clinician.