An exciting group of investigational therapies for metastatic renal cancer use cellular preparations. Technical advances accommodate testing strategies to repair, bypass or direct the immune system to defeat the pathologic absence of effective antitumor response. These can be organized by corresponding steps of the immune process: passive infusion of effectors isolated from blood, tumor or lymph nodes draining a vaccinated area; nonmyeloablative transplantation with stem cells plus lymphocytes specific for alloantigens, including tumor antigens, and reconstitution of antigen presentation by dendritic cells or modified tumor cells. Key monitoring of treatment outcome includes conventional clinical response measurement and also correlative assays as benchmarks of theoretically useful immunologic events. Broad efforts with innovative treatments may portend real progress for metastatic renal cancer immunotherapy.