How is tx of metastatic RCC?

Nephrectomy Approximately one third of patients with RCC exhibit metastatic disease at the time of initial presentation Chemotherapy : resistance Radiation Therapy: resistance Immunobiologic Therapy: A review of clinical results in 1714 patients treated with IL-2 monotherapy indicated an overall objective response rate of 15.4% Now , the new era of immunotherapy check point inhibitors of PD -1( present on T cells ) and PD-L1 ( present on the tumor cells) are introduced as second line therapy after the TKI target therapy Targeted therapy Tyrosine kinase inhibitors (TKI): anti angiogenesis most recent ++