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HEALTH PROFESSIONAL · SOURCE READING

Treatment Options for Third- and Fourth-Line Therapy for Stage IV Renal Cell Cancer

Source: Renal Cell Cancer Treatment (PDQ®)–Health Professional Version, National Cancer Institute.

Source updated: May 13, 2025 · Captured 2026-09-09.

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Context: Treatment of Stage IV and Recurrent Renal Cell Cancer

Treatment options for third- and fourth-line therapy for stage IV renal cell cancer include:

Tivozanib.[26,27]

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Pazopanib.[14,15,28]

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Sorafenib.[29,30]

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Temsirolimus.[31]

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Bevacizumab with or without interferon alfa.[32-35]

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Axitinib.[36]

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Everolimus (for patients previously treated with sunitinib and/or sorafenib).[37]

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Any of the agents listed for first- or second-line therapy.

The prognosis is poor for any patient with renal cell cancer that is progressing, recurring, or relapsing after treatment, regardless of cancer cell type or stage of disease. Almost all patients with stage IV renal cell cancer have incurable disease. The use and selection of further treatment depends on many factors, including previous treatment and site of recurrence, as well as individual patient considerations. Carefully selected patients may benefit from surgical resection of localized metastatic disease, particularly if they have had a prolonged disease-free interval since their primary therapy.

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Preserved source evidence · Not medical advice