德国每年约有 15,000 人被诊断为肾细胞癌 (RCC)； 20-30% 的病例在诊断时已存在转移性肾细胞癌 (mRCC)。这种处于转移阶段的疾病仍主要采用姑息治疗，但多模式治疗格局在过去 15 年中发生了显着变化，许多针对 mRCC 患者的新疗法获得批准。本综述基于选择性搜索检索到的前瞻性研究PubMed、ASCO 和 ESMO 数据库以及德国和欧洲 RCC 肿瘤学和泌尿学指南。药物是治疗的支柱。 mRCC 可以联合使用两种免疫检查点抑制剂 (CPI)、CPI 和酪氨酸激酶抑制剂 (TKI)（证据级别 IA）或 TKI 作为单一疗法（证据级别 IIC-IC）。通过基于预后的序贯药物治疗，从一线治疗开始起，平均无进展生存期为 12 至 24 个月，总生存期约为 50 个月。除了药物治疗外，多学科肿瘤委员会还应根据个体预后情况和患者目前的状况，评估局部治疗的适应症，例如肿瘤细胞减灭术、转移瘤切除术和放射治疗。最佳的个体化决策需要高水平的专业知识和多方合作。多学科肿瘤委员会。较旧的预后参数目前在决策中发挥着主导作用，而预测参数和分子标记尚未得到充分验证。

Approximately 15 000 people receive a diagnosis of renal cell carcinoma (RCC) in Germany each year; in 20-30% of cases, metastatic RCC (mRCC) is already present at the time of diagnosis. This disease in the metastatic stage is still mainly treated palliatively, yet the multimodal therapeutic landscape has changed markedly over the past 15 years, with the approval of many new treatments for patients with mRCC.This review is based on prospective studies retrieved by a selective search in PubMed and the ASCO and ESMO databases and on the German and European oncological and urological guidelines for RCC.Drugs are the mainstay of treatment. mRCC can be treated with a combination of two immune checkpoint inhibitors (CPIs), a CPI and a tyrosine-kinase inhibitor (TKI) (evidence level IA), or a TKI as monotherapy (evidence level IIC-IC). With prognosis-based sequential drug treatment, a mean progression-free survival of 12 to 24 months and an overall survival of approximately 50 months can be achieved from the time of initiation of first-line therapy. Aside from pharmacotherapy, the multidisciplinary tumor board should evaluate the indications for local treatments such as cytoreductive nephrectomy, metastasectomy, and radiotherapy, depending on the individual prognostic constellation and the patient's present condition.Optimal individualized decisions require a high level of expertise and the collaboration of a multidisciplinary tumor board. Older prognostic parameters currently play a leading role in decision-making, while predictive parameters and molecular markers are not yet adequately validated.