Therapies currently approved in renal cell carcinoma (RCC) include tyrosine kinase inhibitors, immune checkpoint inhibitors, and inhibitors of mTOR signaling. Increased understanding of the biology of clear cell and non–clear cell RCC has led to development of agents that target hypoxia-inducible factor 2 and MET, while there is ongoing exploration of targeting immune pathways other than the programmed death ligand 1 or cytotoxic T-lymphocyte–associated protein 4 checkpoints. Drug development in RCC is moving toward the study of combination therapies and attempting to use a risk-adapted approach in treatment. While the past decade has seen the approval of several new therapies, there is an urgent need to focus drug development on novel targets and expand the therapeutic armamentarium in both clear cell and non–clear cell kidney cancer. This review provides an overview of the key targets currently undergoing clinical evaluation, as well as how drug development has evolved over the past 20 years and what the new few years may hold.

目前批准用于肾细胞癌 (RCC) 的疗法包括酪氨酸激酶抑制剂、免疫检查点抑制剂和 mTOR 信号抑制剂。对透明细胞和非透明细胞RCC生物学的更多了解导致了针对缺氧诱导因子的药物的开发2 和 MET，同时正在探索靶向除程序性死亡配体 1 或细胞毒性 T 淋巴细胞相关蛋白 4 检查点以外的免疫途径。RCC 的药物开发正在转向联合疗法的研究，并试图在治疗中使用风险适应方法。虽然在过去十年中已经看到了几种新疗法的批准，但迫切需要将药物开发集中在新靶点上，并扩大透明细胞和非透明细胞肾癌的治疗设备。本综述概述了目前正在进行临床评估的关键靶点，以及过去 20 年药物开发的演变以及新几年可能发生的情况。