A Phase II Study Assessing Stereotactic Radiotherapy in Therapeutic Strategy of Oligoprogressive Renal Cell Carcinoma Metastases

Inclusion Criteria: * Clear cell renal cancer histologically proved (association with other histologic component are permitted) * Patients of good or intermediate prognostic, according to Heng criteria * Extracerebral metastatic disease documented with imagery * Patients treated in first or second line systemic therapy * Systemic treatment may be targeted therapies (tyrosine kinase inhibitors or mammalian target of rapamycin inhibitors) and/or immunotherapy according to French applicable standards; patients treated in a clinical trial are also eligible if allowed by trial sponsor * Oligoprogressive disease documented with imagery, defined as the emergence or progression of 1 to 3 metastases and progression localized in up to 2 organs * Oligoprogressive disease confirmed with 2 CT scans performed 2 months apart * At least one measurable progressing metastasis according to R.E.C.I.S.T. criteria v1.1 * All oligoprogressive target lesions measuring ≤ 4 cm * Good general condition (WHO performance status ≤ 2) * All progressive lesions have to be accessible to SRT, performed concurrently or sequentially * No contraindication to systemic therapy and stereotactic radiation therapy * Patients aged 18 years or older * Signed informed consent form * Patients affiliated to the social security system Exclusion Criteria: * More than 3 progressive metastases * Non measurable disease according R.E.C.I.S.T. criteria * Patients who received 3 or more lines of systemic therapy * Inability to treat all progressive metastatic sites with SRT * Previous radiation therapy performed in ≥ 1 target lesion * At least 1 oligoprogressive target lesion measuring \> 4 cm * Presence of brain metastases * Presence of ultra-central pulmonary metastasis * Progressing metastasis in a long bone * At least 1 progressive metastasis requiring surgical treatment * Current or past history of second neoplasm diagnosed within the last 5 years * Pregnancy or breast feeding or inadequate contraceptive measures * Patients who cannot be adequately followed up * Patient deprived of freedom or under guardianship