This video explores the evolving role of biomarkers in kidney cancer treatment, especially as more therapies become available for both metastatic and adjuvant settings. Key questions include which therapy to choose, potential side effects, and the necessity of treatment. Experts discuss how biomarker advancements, from traditional histology to advanced single-cell genomics, are helping address these concerns. Although progress is being made, the routine clinical use of biomarkers remains limited, highlighting the need for further development in this space.