Medical treatment of metastatic kidney cancer: targeting the tumor micro-environment. Metastatic kidney cancer has a poor prognosis. Progress has been made in recent years with the development of drugs targeting the tumor microenvironment, namely angiogenesis and immune infiltrate. First-line drugs inhibit neo-angiogenesis and target the vascular endothelial growth factor receptor. Nivolumab is an anti-PD1 human monoclonal antibody that, by binding to its target, interrupts binding with its ligand PD-L1 and thus restores T-cell activation and destroys the tumor cell. The median overall survival of patients is about 2 years.