VHL and renal cell carcinoma: From this point of view it is interesting to note that the survival of patients with poor prognostic metastatic RCC according to the Memorial Sloan-Kettering Hospital Cancer Center (MSKCC) classification is increased by using mTOR inhibitors that do not target specifically the VHL/VEGF pathway (Hudes et al, 2007; Motzer et al, 2008).