CYP3A4 and hereditary clear cell renal cell carcinoma: VEGF TKIs used in renal cell carcinoma (RCC) treatment, sunitinib, sorafenib, lenvatinib, cabozantinib, pazopanib, axitinib, and tivozanib, are also metabolized by CYP3A4, but not all interactions are clinically relevant: lenvatinib is not affected by strong CYP3A4 inhibitors or inducers, sorafenib and tivozanib are not affected by CYP3A4 inhibitors, while the association with inducers of all drugs except lenvatinib should be avoided or dose adjustments should be made [31].