Avelumab, an anti-PD-L1 antibody, in combination with axitinib, a VEGFR-targeted TKI, has demonstrated efficacy in pivotal trials such as JAVELIN Renal 101.<h4>Objective</h4>The objective of this study is to report the clinical outcomes of four patients with advanced mRCC and extensive metastases treated with avelumab with axitinib at the Kuwait Cancer Control Center (KCCC).<h4>Methods</h4>This case series describes diagnostic imaging, treatment regimens, and disease progression in four patients. Here, CD274 is linked to cancer.