The treatment of locally advanced, inoperable or metastatic kidney tumors is a dynamically changing field of oncology. Since the registration of the first targeted therapeutic product (2005), more and more new products have been internationally accepted and registered almost every year. The development of immune checkpoint inhibitors and their inclusion in care algorithms (2015) further expanded the therapeutic possibilities. Despite all this, the optimal selection of medication used in different therapeutic lines poses a significant challenge to clinicians. In this review we have collected the data, aspects, and results of clinical tests necessary for the choice of therapy that can be applied in second and further lines. We also present the domestic treatment options.