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Therapy options for patients with advanced renal cell cancer have evolved rapidly during the past few years. In a series of clinical trials, researchers have demonstrated that small molecules that target the vascular endothelial growth factor (VEGF) pathway have substantial clinical activity. In addition, the epidermal growth factor receptor (EGFR) pathway has been a target of interest, because one of its ligands, transforming growth factor α, often is elevated in patients with advanced renal cell cancer. In a phase II trial of the EGFR inhibitor erlotinib (Tarceva) in combination with bevacizumab (Avastin, an antibody against VEGF; J Clin Oncol 2005; 23:7889), intriguing evidence of benefit was found, which led U.S. investigators to design…