The development of targeted agents has substantially improved clinical outcomes for patients with metastatic renal cell carcinoma. The optimum duration of treatment with these agents is not yet clear, particularly as targeted agents may often result in disease stabilization as well as in tumour response. Some clinicians may choose to switch to an alternative agent in the absence of tumour response or in the event of the occurrence of side effects, which can result in patients moving rapidly through the available treatment options. This review evaluates the duration of treatment observed with targeted agents that are approved for first-line treatment of metastatic renal cell carcinoma and considers the reasons for switching or discontinuing therapy. In addition, practical strategies for achieving optimal treatment duration, through adverse event management, are discussed.

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