Before the approval of nivolumab, cabozantinib and the lenvatinib-everolimus combination in 2018, options for second-line therapy for patients with advanced RCC who had progressed after initial VEGF-targeted systemic therapy included the VEGFR TKI axitinib [14] or the mammalian target of rapamycin inhibitor (mTORi) everolimus [15]. Here, VEGFA is linked to renal cell adenocarcinoma.