This review highlights recent contributions to the biology and treatment of renal cell carcinoma, the expanded use of antiangiogenic agents as well as interest in other inhibitory drug mechanisms. In addition, recent findings are reported on biomarkers which are undergoing investigation as correlative prognostic indicators of either survival or response to treatment.Advances in our understanding of the molecular biology underpinning renal cell carcinoma and the introduction of new targeted therapeutics with benefit in the metastatic setting have had a major impact on the treatment of this disease.The management of metastatic renal cell carcinoma has undergone a dramatic evolution in the past year, marked by the approval of two drugs by the US Food and Drug Administration. These drugs have demonstrated improved progression-free survival as well as potentially improved overall survival for patients with metastatic disease. These groundbreaking treatment strategies have fueled a surge in translational studies expanding our knowledge of the molecular biology of renal cell carcinoma.