For many cancer entities, such as breast (hormone receptor, Her2), colon (EGFR, BRAF, PI3K, PTEN, or NRAS mutation), or lung cancer (BRCA1/2 mutation, ALK/ ROS1 rearrangement), the utilization of predictive biomarkers became routine years ago and made personalized medicine a reality, but not for mRCC [11,12,13,14]. The gene discussed is NRAS; the disease is lung carcinoma.