**1. Introduction**

cytokine-pretreated patients with advanced renal cell carcinoma (RCC). J Clin Oncol

[27] Eisen, T, Joensuu, H, Nathan, P, Harper, P, Wojtukiewicz, M, Nicholson, S, et al. (2009). Phase II study of BAY a multikinase inhibitor, in previously untreated patients with

metastatic or unresectable renal cell cancer. J Clin Oncol 27: 5033., 73-4506.

27: 5021.

156 Renal Tumor

Kidney cancer comprises 2-3% of all cancers according to Cancer Research UK statistics. (http:// info.cancerresearchuk.org). Renal Cell Carcinomas (RCC) is the most common subtype (around 90%) with clear-cell variant constituting up to 75% of all RCCs. Non clear-cell variant are less common and consist of papillary (Type I and II; 10-15%), chromophobe (4%) and collecting duct (including the rare medullary variant; <1%). [1, 2] At initial diagnosis, one third of patients have evidence of distant metastases, and amongst patients who undergo curative nephrectomy, a third will have a recurrence within 5 years. Historically, treatment options have been limited in metastatic RCC, as cytotoxic chemotherapy is not effective in this disease and immunotherapy is of modest benefit. [1] The treatment outlook for metastatic RCC has changed in the past decade, with the introduction of new therapeutic agents which target molecular pathways involved in tumour angiogenesis.
