. 2011 Jun 2;2:333–338. doi: 10.7150/jca.2.333

Table 1.

A proposed algorithm of treatment for advanced RCC (in bold are reported the options supported by at least one randomized, controlled, phase III, clinical trial).

1st line
	MSKCC* good and intermediate risk	Sunitinib
		Bevacizumab + Interferon-a
		Pazopanib
		Sorafenib (selected patients)
		High-dose i.v. IL-2 (?)
	MSKCC* poor risk	Temsirolimus
	MSKCC* poor risk	Sunitinib
2^nd line
	Post-cytokines	Sorafenib
		Pazopanib
		Sunitinib
	Post-one multi-kinase inhibitor	Everolimus
	Post-one multi-kinase inhibitor	a second multi-kinase inhibitor
3^rd line
	Post-two multi-kinase inhibitors	Everolimus
	Post-Everolimus	Clinical trial
	Post-Everolimus	Sorafenib (?)

*MSKCC (or Motzer's) score takes into consideration the following parameters: ECOG Performance Status, hemoglobin levels, LHD levels, corrected calcium levels, and prior history of nephrectomy - or interval between diagnosis and treatment start; 0 risk factors = good risk; 1-2 risk factors = intermediate risk; >2 risk factors = poor risk.