通过介绍PI3K/AKT/mTOR信号通路及其在肾癌中的作用，探讨mTOR抑制剂依维莫司在肾癌靶向治疗中分别作为一线、二线和序贯治疗的效果，简述其不良反应。依维莫司单用作为一线治疗效果欠佳，支持肾癌治疗指南中依维莫司用于晚期肾癌抗血管生成酪氨酸激酶抑制剂治疗失败的二线治疗策略。依维莫司联合其他药物用于一线治疗的方案值得进一步研究。依维莫司治疗总体耐受性较好，但其引起的3～4级不良反应比率较高仍是亟需解决的问题。

The efficacy of mTOR inhibitor everolimus for targeted first-line, second-line, and sequential treatments of renal cell carcinoma is investigated and adverse reactions are summarized through introducing the PI3K/AKT/mTOR signaling pathways and their roles in renal cell carcinoma. It has been shown that everolimus alone has poor efficacy in first-line treatment, supporting the strategy mentioned in renal cell carcinoma treatment guidelines that everolimus can be used in second-line treatment after unsuccessful treatment with anti-angiogenic tyrosine kinase inhibitors. First-line treatment with everolimus plus other drugs requires further investigation. Everolimus has generally good tolerance, but the problem of high rate of grade 3-4 adverse reactions still needs to be solved.