A number of agents are now approved for the treatment of renal cancer. A comparison of two agents, pazopanib and sunitinib, showed similar levels of antitumor activity but distinct side-effect profiles. Symptoms affecting quality of life were somewhat worse with sunitinib. Renal-cell carcinoma is the most common kidney cancer. 1 Up to 30% of patients have metastases at the time of the initial diagnosis. 2 Systemic treatment for patients who have metastatic renal-cell carcinoma with a clear-cell histologic component has shifted from cytokines to drugs targeting angiogenesis. Sunitinib, pazopanib, and five other agents have been approved by the Food and Drug Administration for the treatment of clear-cell, metastatic renal-cell carcinoma. 3 , 4 Among the tyrosine kinase inhibitors, pazopanib and sunitinib are first-line treatment options. Sunitinib has been compared with interferon alfa in patients who had not previously received systemic therapy for renal-cell carcinoma, 5 whereas . . .