Metastatic clear cell renal cell carcinoma: A review of current therapies and novel immunotherapies

• Treatment strategies for metastatic renal cell carcinoma have changed based on advances in basic science.
• In the past 10–15 years the paradigm shifted from non-specific immunotherapy to targeted therapies.
• There is currently a shift from targeted therapies to more specific immunotherapies.
• The literature behind targeted therapies immunotherapies are reviewed.

Treatment of metastatic renal cell carcinoma (mRCC) has changed dramatically in the past 10 years, largely due to advances in understanding of tumor biology. A number of targeted therapies have been shown to improve progression free survival and overall survival as compared to nonspecific immunotherapy. Despite the success of targeted therapies, they have not produced durable responses that have been seen historically with immunotherapy such as IL-2 (interleukin 2) and IFN-α (interferon). The promise of durable responses has caused some to shift research focus from targeted therapies to novel immunotherapies. This article reviews the literature behind the current targeted therapies and describes several novel approaches to immunotherapy that are in various phases of development.