Renal Carcinoma Therapeutics: ccRCC Vs nccRCC, An Unclear And Uneven Struggle to Include Everyone

Abstract

Renal carcinoma (RCC) accounts for roughly 2% of global cancer diagnoses, with over 430,000 new cases and 150,000+ deaths annually as of 2022. Major contributors include obesity, smoking, hypertension, and occupational exposure, with up to 34% of cases considered preventable. RCC is a malignant neoplasm of the renal tubular epithelium, primarily classified into three main histological subtypes: clear cell (65–75%), papillary (10–15%), and chromophobe (5%) and other histologies, most commonly categorized as clear cell RCC (ccRCC) and non-clear cell RCC (nccRCC), respectively. nccRCC is a heterogeneous group comprising about 20–30% of all kidney cancers, with over 10 recognized, distinct histological subtypes rather than a single type. The therapeutic algorithm for ccRCC is straightforward according to guidelines of every oncologic society even if the use of certain biomarkers in order for certain therapy module to be matched with certain subpopulations. In contrast, the therapeutic algorithm of nccRCC is not such a solid pathway that includes also the possibility of a clinical trial. There have been many advancements in the last year into renal cell carcinoma management that may alter the current status and improve the survival of these patients.