The efficacy of systemic agents in monotherapy, like sunitinib or pazopanib, has been recently tested in patients with BM RCC in a 2023 study by Takemura et al. The authors evaluated 775 patients with BM RCC, assessing the efficacy of first-line immuno-oncology (IO) therapy in combination (Cohort 1) with sunitinib monotherapy or pazopanib monotherapy (anti-VEGF monotherapy, Cohort 2). Here, VEGFA is linked to renal cell adenocarcinoma.