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Treatment of Stage IV and Recurrent Renal Cell Cancer
Source: Renal Cell Cancer Treatment (PDQ®)–Patient Version, National Cancer Institute.
Source updated: May 12, 2025 · Captured 2026-09-09.
Selected source text with whitespace normalised. This Triangle page is not an NCI PDQ summary. Independent clinical review is pending.
First-line treatment of stage IV renal cell cancer may include:
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ipilimumab plus nivolumab
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pembrolizumab plus axitinib
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pembrolizumab plus lenvatinib
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nivolumab plus cabozantinib
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radical nephrectomy
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nephrectomy to reduce the size of the tumor in people with certain favorable tumor types
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cabozanitnib
avelumab plus axitinib
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sunitinib
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pazopanib
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sorafenib
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temsirolimus
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bevacizumab with or without interferon
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interferon
interleukin-2
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palliative radiation therapy
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Second-line treatment may include:
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nivolumab (for people previously treated with sunitinib, pazopanib, sorafenib, and/or axitinib)
lenvatinib plus everolimus (for people previously treated with sunitinib, pazopanib, cabozantinib, axitinib, or sorafenib)
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cabozantinib (for people previously treated with sunitinib, pazopanib, sorafenib, or axitinib)
axitinib
everolimus (for people previously treated with sunitinib and/or sorafenib)
sorafenib
palliative radiation therapy
Third-line and fourth-line treatment may include:
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tivozanib for people who have had at least two other types of systemic treatments
any of the treatments listed for first-line or second-line therapy
Learn more about these treatments in the Treatment Option Overview.
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Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
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Preserved source evidence · Independent clinical review pending · Not medical advice