SAbR For Oligo-Progressive Renal Cell Cancer.

Inclusion Criteria:

Pathology proven renal cell carcinoma and radiographic confirmation of metastatic renal cell carcinoma
Patients must have drug responsive RCC as determined by treating medical or radiation oncologist after at least one set of scans.

Must be on systemic therapy with radiographic scans to verify olio-progression of ≤3 sites and ≤ 30% of all sites.

• Any FDA approved systemic therapy for RCC is allowed. Currently these include small molecule tyrosine kinase inhibitors (TKIs) targeting the vascular endothelial growth factor (VEGF) pathway (sunitinib, pazopanib, cabozantinib, axitinib, sorafenib), monoclonal antibody targeting the same pathway (bevacizumab), the mammalian target of rapamycin pathway (temsirolimus, everolimus), Immune checkpoint inhibitors (Nivolumab and Nivolumab concurrent with Ipilimumab, Lenvatinib in combination with everolimus and nivolumab).

Must be at least 18 years old
ECOG 0-2; or KPS > 60

Currently receiving 1st - 4th line of systemic therapy

• Any of the above listed systemic therapy is allowed as long as they are being used in the 1st-4th line setting.

Ability to understand and the willingness to sign a written informed consent.
Acceptable tolerability of ongoing therapy as decided by the treating medical oncologist
Patient must have a desire to continue ongoing therapy

All men, as well as women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 90 days following completion of therapy. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.

A female of child-bearing potential is any woman (regardless of sexual orientation, marital status, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria:

Has not undergone a hysterectomy or bilateral oophorectomy; or
Has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding 12 consecutive months

Exclusion Criteria:

Subjects with ≥3 unfavorable prognostic factors defined by IMDC (International Metastatic Renal Cell Carcinoma).
Subjects with history of or new brain metastasis.