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At the time of this writing, there have been tectonic shifts in the paradigms and algorithms of renal cell cancer (RCC) treatment. Current FDA approved therapeutics and their clinical applications are reviewed here. Recent successes in the immunotherapy arena has encouraged thinking on how to combine immunotherapies with the well-established anti-angiogenesis tyrosine kinase inhibitors. This chapter highlights recent treatment regimens and is intended to be a practical review for clinicians.