Furthermore, in 2007, the United States Food and Drug Administration and the European Medicines Agency approved mTOR inhibitor temsirolimus as a first-line therapy for poor-risk patients with metastatic ccRCC, and the National Comprehensive Cancer Network (NCCN) Kidney Cancer Panel has listed temsirolimus as category 1 for front-line treatment of poor-risk patients since temsirolimus, in the phase III NCT0065468 trial which included 626 patients (69% with poor- and 31% with intermediate-risk characteristics), achieved longer progression-free and overall survival [22]. This evidence concerns the gene MTOR and nonpapillary renal cell carcinoma.