Guidelines in Metastatic Rcc

primary endpoint, but also the secondary endpoints that should corroborate the primary endpoint, will stand. This approach is based on the Prentice principle, which states that a result has a higher probability of being truly positive if other related endpoints are also positive 1. An advantage in progression-free survival (pfs) has more chance of being true if a statistically significant advantage is also present for other aspects of efficacy such as response rate, time to treatment failure, and survival (if these data are available). Remembering the Prentice principle, it will therefore be the prerogative of the editorial nature of the present paper to determine whether recommendations present in more than one guideline are likely to have a potential to affect practice. This paper also tries to comment on the reasons for the selection of certain treatment options and whether previous recommendations based on older data still apply in view of the treatment options that have so drastically modified the prognosis and survival of patients with metastatic rcc.