[New therapeutic opportunities in metastatic renal cell carcinoma].

Until recently metastatic renal cell carcinoma was considered refractory to the available therapies. A better understanding of the molecular biology and the introduction of targeted agents led to a significant improvement in the prognosis of patients with metastatic renal cell carcinoma. In this paper the molecular pathology, specifically the deregulation of the oxygen adaption mechanisms leading to tumorangiognesis will be presented. Based on these fundamental mechanisms the targeted agents will be introduced. These agents have been tested in randomized phase III trials in different clinical and prognostic situations. The results and the side-effects of sunitinib, sorafenib, temsirolimus, everolimus and bevacizumab treatment will be presented leading to a possible treatment algorithm.