The majority (75%) of RCC cases have a clear cell histology (ccRCC), to which most first-line treatment regimens are specialized. The next most common histology is papillary RCC, comprising 15% of RCCs. 

Nearly all approved drugs in the disease space are for metastatic RCC. Sutent or Keytruda may be prescribed as postoperative adjuvant therapies in locoregional disease, but the typical approach is nephrectomy alone. Welireg has also been approved for advanced disease, but was initially limited to treating patients with germline loss of function mutations in the tumor suppressor gene von Hippel-Lindau (VHL). In 2023, Welireg received a label expansion for patients who have progressed on a VEGF-targeted therapy and a PD-1/PD-L1 inhibitor, allowing it to target a larger patient population.