The advent of multi-tyrosine kinase inhibitors (TKIs) or antibodies targeting the VEGF axis clearly had a significant and broad impact on the natural history of advanced renal cell carcinoma; however, durable response is rare (5–14), and therefore the development of new options that are tolerable and have the potential for durable responses remains an area of active investigation. This evidence concerns the gene VEGFA and renal cell carcinoma.