Background: Although sunitinib is approved treatments in first-line therapy for patients with metastatic renal cell carcinoma(mRCC).In the second-line treatment choices consist of axitinib and everolimus.A programmed death-1(PD1)checkpoint inhibitor,improved overall survival benefit compared to everolimus after failure of one or two VEGFR-targeted therapies.However,data for the sequencing of agents is limited.Evidence in the literature on low dose pembrolizumab(a PD1 inhibitor)cocultured with cytokine-induced killer(CIK)combined with axitinib is very scarce.