A review of 36 cytotoxic agents used singly in over 1,900 patients with renal cancer between 1983 and 1988 finds marginal antitumor activity, less than 5-10%. The future role of monoclonal antibodies for therapy of this disease may offer some hope with the recent description of rather specific phenotypic expression, URO 10+/URO 8+, suggesting the cell origin of most renal tumors from the distal portion of the proximal tubule.