Growth factors released from tumors, including VEGF-C, can promote lymphangiogenesis and anterior LN drainage in the primary tumor, thus inducing LNM.348 Many different VEGF-C and VEGF-D/VEGFR-3 pathway-targeting drugs have been developed and demonstrated to offer efficacy as inhibitors of solid tumor LNM.37 Multikinase inhibitors such as Sunitinib, Sorafenib, and Pazopanib, have received approval for the treatment of various cancers including HCC, renal cell carcinoma, and gastrointestinal mesenchymal tumors.348,349. This evidence concerns the gene VEGFC and hereditary clear cell renal cell carcinoma.