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BackgroundThis article describes and compares approved targeted therapies and the newer immunotherapy agents. Materials and methodsThis article especially performs an in-depth review of currently available data for tivozanib, explaining its mechanism of action, its safety profle and its role as an efcacy drug in the management of renal cancer. ResultsDespite the fact that the treatment of advanced RCC has been dramatically modifed in recent years, durable remissions are scarce and it remains a lethal disease. For frst-and second-line therapy, there is now growing evidence to guide the selection of the appropriate treatment. ConclusionsSeveral TKIs are standard of care at diferent settings. Among those approved TKIs, tivozanib has similar efcacy than others with a better safety profle. The use of prognostic factors is critical to the selection of optimal therapy.

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