The treatment landscape for metastatic renal cell carcinoma (mRCC) has undergone a substantial evolution in the past decade, with a dramatic increase in the number of available systemic therapies. Although this offers promise for improved patient outcomes, this rapid pace in development has led to new challenges in therapeutic choice. For instance, the absence of direct comparative evidence across all therapeutic options has led to a critical gap in evidence to clearly define preferred systemic therapy choice. Additionally, the rising cost of systemic therapies being evaluated for mRCC necessitates demonstration of cost-effectiveness prior to widespread adoption. This review provides an overview of the current treatment landscape in mRCC to highlight the emerging challenges faced by clinicians and health policy-makers. In addition, this review summarizes the currently available evidence that aims to address the above challenges.

在过去的十年中，转移性肾细胞癌（mRCC）的治疗方式发生了重大变化，可用的全身疗法数量急剧增加。尽管这为改善患者预后提供了希望，但是这种快速的发展步伐带来了治疗选择方面的新挑战。例如，所有治疗选择之间都没有直接的比较证据，导致在明确定义首选全身治疗选择的证据方面存在严重差距。此外，针对mRCC评估的全身疗法的成本不断上升，因此必须在广泛采用之前证明其具有成本效益。这篇综述概述了mRCC的当前治疗情况，以突出临床医生和卫生政策制定者面临的新挑战。此外，