Role of stereotactic body radiation therapy for the management of renal cell carcinoma: tailoring treatment in the era of the “embarrassment of riches”

The recent advances in the treatment of metastatic renal cell carcinoma (mRCC), from the introduction of the first antiangiogenic tyrosine kinase inhibitor (TKI) sorafenib in 2005 to the most recent approval of the first immune checkpoint inhibitor (CKI) nivolumab in 2015, allowed to improve the management of the disease and most importantly to prolong overall survival (OS) (1,2). In this era, especially after the publication of recent pivotal trials introducing three new therapeutic combinations in the first-line treatment setting (3-5), we can properly talk about the “embarrassment of riches” for the systemic therapy for clear-cell mRCC.