How is tx of locally advanced RCC?

1. Inferior Vena Caval Involvement: Involvement of the inferior vena cava with RCC occurs in 4% to 10% of patients 2. For patients with nonmetastatic RCC involving the vena cava, 5-year survival rates of 47% to 69% have been reported after complete surgical therapy 3. Radical nephrecotmy is the gold standard + targeted therapy ( ?)