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NCCN Guidelines for Patients



Kidney Cancer, Version 1.2017


Treatment guide

Stage IV and relapsed kidney cancer

Guide 8

shows the first-line treatment options for

kidney cancer that can’t be removed by surgery or

that came back (relapsed) after surgery. First-line

treatment is the first drug or set of drugs used to treat

cancer. There are many first-line treatment options to

choose from. Which option is best for you depends

on a number of factors. One key factor is the cell

subtype. The most common subtype is clear cell

RCC. The other subtypes are much less common.

Therefore, they are simply referred to as “non-clear

cell.” (See page 22 for more details.)

First-line treatment

Treatment within a clinical trial is an option for all

patients. Many new drugs have been approved for

kidney cancer in the past 10 years because of clinical

trials. But, most of the studies focused on clear cell


Guide 8. First-line treatment with drugs

Clear cell RCC treatment options

Non-clear cell RCC treatment options

• Clinical trial

• Clinical trial

• Pazopanib

• Sunitinib

• Sunitinib

• Axitinib

• Bevacizumab + interferon alfa

• Bevacizumab

• Temsirolimus (for certain patients)

• Cabozanitinib

• Axitinib

• Erlotinib

• High-dose IL-2 (for certain patients)

• Everolimus

• Sorafenib

• Levatinib + everolimus

• Nivolumab

• Pazopanib

• Sorafenib

• Temsirolimus (for certain patients)

• Best supportve care is an option for both clear cell and non-clear cell RCC