At the Thirteenth International Kidney Cancer Symposium, Prof David Kwiatkowski (Brigham and Women’s Hospital, MA) discusses targeting the mTOR pathway in kidney cancer treatment. It may be clinically necessary to target different proteins, mTOR, TSC1 and TSC2, of the mTOR pathway. Mutations in genes encoding for these proteins correlate with therapeutic response, and this may influence clinical trial design and provide the basis for personalised medicine in kidney cancer.