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Survival among patients with metastatic renal cell carcinoma has been prolonged with advancements in treatment; however, its cure remains challenging. We describe three patients with metastatic renal cell carcinoma who showed long‐term survival and discuss their response to sequential therapy.    Case presentation  Three patients underwent radical nephrectomy and subsequent treatment for metastatic renal cell carcinoma. They received cytokine therapy, target therapy, and an immuno‐oncology drug. Metastatic growth patterns based on computed tomography scans were plotted using a line or bar graph to visualize the response to sequential therapy, and the numbers of International Metastatic renal cell carcinoma Database Consortium risk score were also calculated.    Conclusion  The metastatic lesions responded differently to the administered drugs, and the sum of the axis of measurable metastasis is valuable to get an overview of treatment. Furthermore, having the same or lower International Metastatic renal cell carcinoma Database Consortium risk score during sequential therapy, and long duration of each target therapy contributed to prolonged survival.

Spatial and temporal responses of metastatic renal cell carcinoma lesions to sequential treatments over a 10‐year period