<s>[INST] How quickly will a patient with stage IV renal carcinoma deteriorate when last hope drugs (Sutent) begin to fail?  Patient is 42 year old male, has taken Sutent for 10 months with some tumour regression, but recent scans show a reappearance of lung mets. [/INST] Thanks for your question on Chat Doctor. I can understand your situation and problem. Honestly speaking, stage 4 renal cancer with lung metastasis carries very bad prognosis. And failing chemotherapy adds further poorer prognosis. So better to discuss end of life issues with the patient. Start palliative treatment in the form of nutrition and pain management. Life expectancy is less than 1 year. And five year survival rate is very, very less (less than 10%). </s>