Predictive factors for sunitinib treatment response in advanced renal cell carcinoma: are we really making steps forward?

Renal cell carcinoma is an aggressive neoplasm, frequently diagnosed incidentally in an advanced stage (local or metastatic). Sunitinib is a small molecule that inhibits multiple receptor tyrosine kinases, mainly directed against the angiogenic pathway. Sunitinib is largely used in first-line treatment, but response varies widely among patients. Thus, there is an urgent need to find predictive factors able to determine whether or not a patient would respond to treatment, thereby avoiding unnecessary toxicities. In this report we review the literature focusing on clinical, pathological, and molecular predictive factors currently being studied and more promising to enter clinical practice.