More successful treatment of metastatic renal cell carcinoma with targeted therapies compared to immunotherapy brought the idea of adjuvant and neoadjuvant use of these agents especially in locally advanced kidney tumors with high risk of recurrence. Clinical trials regarding adjuvant and neoadjuvant targeted therapies for non-metastatic renal cell carcinoma will be discussed in this review. Today, there is no data demonstrating overall or disease-free survival advantages of adjuvant or neoadjuvant targeted therapies in non-metastatic renal cell carcinoma. Ongoing clinical adjuvant trials which mostly use standardized scoring systems for relapse risk stratification will both provide more clear information for us and also help us for establishing which patients groups need adjuvant therapy. Neoadjuvant targeted therapies for nonmetastatic renal cell carcinoma may have some limited value for tumors that are considered to be unresectable, for tumors with high morbidity and mortality rates if operated and also for tumors with absolute indication for partial nephrectomy. Targeted therapies in the adjuvant and neoadjuvant settings for patients with non-metastatic renal cell carcinoma is still experimental. Results of the ongoing adjuvant and neoadjuvant clinical trials with localised and locally advanced renal cell carcinoma will better inform us about the efficacy and safety of targeted therapies. (Bulletin of Urooncology 2014;13:139-145)

Keywords: Kidney cancer, targeted therapy, adjuvant, neoadjuvant