Chromophobe renal cell carcinoma: the decisions you may face

Cancer page →Second-opinion finder →

3 treatment settings, 2 with more than one named option. Each section lays out the options the standard of care names, what each is for, the trials behind them with their recorded results, the side effects and cautions on record, and questions to ask. Built from the cancer page's standard-of-care rows; nothing here is advice for your case.

Early / localised

Localised

2 options

Partial nephrectomy or ablation; active surveillance for small tumours; no adjuvant therapy.

The options, in plain words

Thermal ablation (RFA, microwave, cryo)Standard of care

Thermal ablation kills a tumour with heat or cold delivered through a needle, with no incision required.

Outpatient, repeatable
Preserves organ function

Active surveillanceStandard of care

For low-risk prostate cancer, monitoring with PSA, MRI, and repeat biopsy instead of treating, because most such cancers never cause harm.

Avoids incontinence and erectile dysfunction of treatment in men who would never be harmed
Level-1 evidence of safety (ProtecT)

The evidence behind it

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

The main trade-offs on record

Thermal ablation (RFA, microwave, cryo)

Size limit ~3 cm
Heat-sink near vessels

Active surveillance

Anxiety and adherence
Repeat biopsies
Under-used outside high-income countries

Questions to ask about this decision

Between Thermal ablation (RFA, microwave, cryo) and Active surveillance, which do you recommend for me, and what about my case would make you choose differently?
Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
Why: The aim shapes how much side effect and disruption is worth accepting.
What happens if I delay, or decline this step for now? Is the decision reversible?
Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
For my situation (localised), which of the standard options do you recommend and why?
Why: Guideline options include: Partial nephrectomy or ablation; active surveillance for small tumours; no adjuvant therapy.

Add these to your appointment list, or take the full question set for this cancer.

Advanced, first line

Metastatic

4 optionsCompare side by side →

Sunitinib, cabozantinib, everolimus or lenvatinib plus everolimus; immunotherapy has low response rates outside sarcomatoid disease; trials preferred.

The options, in plain words

SunitinibApprovedSmall-molecule multi-kinase inhibitor (VEGFR, PDGFR, KIT)

Sunitinib is an anti-angiogenic pill approved for pancreatic neuroendocrine tumours, kidney cancer and GIST.

CabozantinibApprovedSmall-molecule multi-kinase inhibitor (MET, VEGFR2, AXL, RET)

A pill that blocks both blood-vessel growth and the MET escape pathway, used in kidney, liver, thyroid and, since 2025, neuroendocrine cancers.

EverolimusApprovedSmall-molecule mTOR inhibitor

An mTOR-blocking pill that doubled progression-free time with exemestane in 2012 and is now paired with the oral SERD giredestrant.

LenvatinibApprovedSmall-molecule multi-kinase inhibitor (VEGFR, FGFR, PDGFR, RET, KIT)

An oral anti-angiogenic pill that matched sorafenib in liver cancer with higher response rates, and partners with pembrolizumab in kidney and endometrial cancer.

The evidence behind it

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

The main trade-offs on record

Sunitinib all recorded rates →

Avoid grapefruit.
Known QT prolongation. Avoid other QT-prolonging drugs where possible; check ECG and correct potassium and magnesium before and during treatment.

Cabozantinib all recorded rates →

Tablets: take on an empty stomach (no food 2 hours before or 1 hour after). Avoid grapefruit.
Reduce to 40 mg daily in moderate impairment; avoid in severe.

Everolimus all recorded rates →

Avoid grapefruit. Live vaccines are contraindicated.
7.5 mg (mild), 5 mg (moderate), 2.5 mg (severe).

Lenvatinib all recorded rates →

Known QT prolongation. Avoid other QT-prolonging drugs where possible; check ECG and correct potassium and magnesium before and during treatment.
Reduce to 14 mg (thyroid) or 10 mg (RCC) in severe impairment.
Reduce in severe renal impairment.

Questions to ask about this decision

Between Sunitinib, Cabozantinib, Everolimus and the other options, which do you recommend for me, and what about my case would make you choose differently?
Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
Why: The aim shapes how much side effect and disruption is worth accepting.
What happens if I delay, or decline this step for now? Is the decision reversible?
Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
For my situation (metastatic), which of the standard options do you recommend and why?
Why: Guideline options include: Sunitinib, cabozantinib, everolimus or lenvatinib plus everolimus; immunotherapy has low response rates outside sarcomatoid disease; trials preferred.
Am I a candidate for Sunitinib, Cabozantinib, Everolimus or related drugs, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Add these to your appointment list, or take the full question set for this cancer.

Other settings

Birt-Hogg-Dube syndrome

Described in words

Kidney surveillance with MRI, nephron-sparing surgery at 3 cm, and genetic counselling.

The path, in plain words

This setting names no product or technology record yet; the approach above is the standard as written. Ask your team which specific treatments they mean.

Also referenced:Renal cell carcinoma

The evidence behind it

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

The main trade-offs on record

No side-effect rates or interaction flags are recorded for these options yet. The side-effect lookup and interaction checker cover the products that have them.

Questions to ask about this decision

Which specific treatments are you proposing for this setting, and what are the alternatives?
Why: The standard of care here is described in words rather than named products; ask for the names.
What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
Why: The aim shapes how much side effect and disruption is worth accepting.
What happens if I delay, or decline this step for now? Is the decision reversible?
Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
For my situation (birt-hogg-dube syndrome), which of the standard options do you recommend and why?
Why: Guideline options include: Kidney surveillance with MRI, nephron-sparing surgery at 3 cm, and genetic counselling.

Add these to your appointment list, or take the full question set for this cancer.

How to read this page. Options and results come from OnCo records with their sources; the settings are the standard-of-care rows on the cancer page, and the lines of therapy are on the sequencing grid. Where a setting names one path, the choice is usually about timing, trials and where to be treated: see expert centres. OnCo is orientation, not medical advice.

Living with cancer·Standard of care

Chromophobe renal cell carcinoma: the decisions you may face

Cancer page →Second-opinion finder →

Early / localised

Localised

2 options

Partial nephrectomy or ablation; active surveillance for small tumours; no adjuvant therapy.

The options, in plain words

Thermal ablation (RFA, microwave, cryo)Standard of care

Thermal ablation kills a tumour with heat or cold delivered through a needle, with no incision required.

Outpatient, repeatable
Preserves organ function

Active surveillanceStandard of care

For low-risk prostate cancer, monitoring with PSA, MRI, and repeat biopsy instead of treating, because most such cancers never cause harm.

Avoids incontinence and erectile dysfunction of treatment in men who would never be harmed
Level-1 evidence of safety (ProtecT)

The evidence behind it

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

The main trade-offs on record

Thermal ablation (RFA, microwave, cryo)

Size limit ~3 cm
Heat-sink near vessels

Active surveillance

Anxiety and adherence
Repeat biopsies
Under-used outside high-income countries

Questions to ask about this decision

Between Thermal ablation (RFA, microwave, cryo) and Active surveillance, which do you recommend for me, and what about my case would make you choose differently?
Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
Why: The aim shapes how much side effect and disruption is worth accepting.
What happens if I delay, or decline this step for now? Is the decision reversible?
Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
For my situation (localised), which of the standard options do you recommend and why?
Why: Guideline options include: Partial nephrectomy or ablation; active surveillance for small tumours; no adjuvant therapy.

Add these to your appointment list, or take the full question set for this cancer.

Advanced, first line

Metastatic

4 optionsCompare side by side →

Sunitinib, cabozantinib, everolimus or lenvatinib plus everolimus; immunotherapy has low response rates outside sarcomatoid disease; trials preferred.

The options, in plain words

SunitinibApprovedSmall-molecule multi-kinase inhibitor (VEGFR, PDGFR, KIT)

Sunitinib is an anti-angiogenic pill approved for pancreatic neuroendocrine tumours, kidney cancer and GIST.

CabozantinibApprovedSmall-molecule multi-kinase inhibitor (MET, VEGFR2, AXL, RET)

A pill that blocks both blood-vessel growth and the MET escape pathway, used in kidney, liver, thyroid and, since 2025, neuroendocrine cancers.

EverolimusApprovedSmall-molecule mTOR inhibitor

An mTOR-blocking pill that doubled progression-free time with exemestane in 2012 and is now paired with the oral SERD giredestrant.

LenvatinibApprovedSmall-molecule multi-kinase inhibitor (VEGFR, FGFR, PDGFR, RET, KIT)

An oral anti-angiogenic pill that matched sorafenib in liver cancer with higher response rates, and partners with pembrolizumab in kidney and endometrial cancer.

The evidence behind it

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

The main trade-offs on record

Sunitinib all recorded rates →

Avoid grapefruit.
Known QT prolongation. Avoid other QT-prolonging drugs where possible; check ECG and correct potassium and magnesium before and during treatment.

Cabozantinib all recorded rates →

Tablets: take on an empty stomach (no food 2 hours before or 1 hour after). Avoid grapefruit.
Reduce to 40 mg daily in moderate impairment; avoid in severe.

Everolimus all recorded rates →

Avoid grapefruit. Live vaccines are contraindicated.
7.5 mg (mild), 5 mg (moderate), 2.5 mg (severe).

Lenvatinib all recorded rates →

Known QT prolongation. Avoid other QT-prolonging drugs where possible; check ECG and correct potassium and magnesium before and during treatment.
Reduce to 14 mg (thyroid) or 10 mg (RCC) in severe impairment.
Reduce in severe renal impairment.

Questions to ask about this decision

Between Sunitinib, Cabozantinib, Everolimus and the other options, which do you recommend for me, and what about my case would make you choose differently?
Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
Why: The aim shapes how much side effect and disruption is worth accepting.
What happens if I delay, or decline this step for now? Is the decision reversible?
Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
For my situation (metastatic), which of the standard options do you recommend and why?
Why: Guideline options include: Sunitinib, cabozantinib, everolimus or lenvatinib plus everolimus; immunotherapy has low response rates outside sarcomatoid disease; trials preferred.
Am I a candidate for Sunitinib, Cabozantinib, Everolimus or related drugs, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Add these to your appointment list, or take the full question set for this cancer.

Other settings

Birt-Hogg-Dube syndrome

Described in words

Kidney surveillance with MRI, nephron-sparing surgery at 3 cm, and genetic counselling.

The path, in plain words

This setting names no product or technology record yet; the approach above is the standard as written. Ask your team which specific treatments they mean.

Also referenced:Renal cell carcinoma

The evidence behind it

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

The main trade-offs on record

No side-effect rates or interaction flags are recorded for these options yet. The side-effect lookup and interaction checker cover the products that have them.

Questions to ask about this decision

Which specific treatments are you proposing for this setting, and what are the alternatives?
Why: The standard of care here is described in words rather than named products; ask for the names.
What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
Why: The aim shapes how much side effect and disruption is worth accepting.
What happens if I delay, or decline this step for now? Is the decision reversible?
Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
For my situation (birt-hogg-dube syndrome), which of the standard options do you recommend and why?
Why: Guideline options include: Kidney surveillance with MRI, nephron-sparing surgery at 3 cm, and genetic counselling.

Add these to your appointment list, or take the full question set for this cancer.