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During the last few years, three new agents have been approved by the FDA for the management of advanced renal cell carcinoma (RCC): sunitinib (Sutent) and sorafenib (Nexavar), both inhibitors of vascular endothelial growth factor (VEGF) receptor tyrosine kinases, and temsirolimus (Torisel), an inhibitor of the mammalian target of rapamycin (mTOR). All three agents have been associated with prolonged progression-free survival (PFS), and sunitinib and temsirolimus have been associated with prolonged overall survival (OS). The current therapy paradigm for patients with advanced disease entails sequential use of these targeted agents in combination with other drugs, and clinical evidence of the benefit of this approach is evolving. For example…