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Updated: May 8, 2026

A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
Non-clear cell renal cancer: disease-based management and opportunities for targeted therapeutic approaches
W Marston Linehan1, Ramaprasad Srinivasan, Jorge A Garcia
1Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA. WML@nih.gov
Abstract:
A better understanding of the biology of renal cell carcinoma (RCC) has significantly changed the treatment paradigm of the disease. Several novel vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) inhibitors have been approved recently by the US Food and Drug Administration. Unfortunately, the vast majority of clinical trials conducted today have been aimed to include patients with clear cell RCC, which remains the most common histologic subtype of the disease. Non-clear cell RCC represents approximately 20%-25% of all RCC patients. Non-clear cell RCC is made up of multiple histologic subtypes, each with a different molecular printing profile. Although VEGF and TORC inhibitors are commonly used in the management of this cohort of patients, non-clear cell histologies do not appear to be related to the von Hippel-Lindau gene (VHL). As such, the clinical efficacy of the existing agents is quite limited. There is a need to develop more rational therapeutic approaches that specifically target the biology of each of the different subtypes of non-clear cell RCC. In this review, we discuss molecular and clinical characteristics of each of the non-clear cell RCC subtypes and describe ongoing efforts to develop novel agents for this subset of patients.
Insights
Novel therapies for non-clear cell renal cell carcinoma (RCC) are needed. Current treatments targeting vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) show limited efficacy in these subtypes.
Area of Science:
- Oncology
- Genitourinary Cancer
- Translational Research
Background:
- Renal cell carcinoma (RCC) treatment has advanced, with new vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) inhibitors.
- Clear cell RCC is the most common subtype, and most clinical trials focus on it.
- Non-clear cell RCC (nccRCC) comprises 20-25% of RCC cases and includes diverse subtypes with distinct molecular profiles.
Purpose of the Study:
- To review the molecular and clinical characteristics of nccRCC subtypes.
- To highlight the limited efficacy of current VEGF and mTOR inhibitors in nccRCC.
- To discuss the need for targeted therapies specific to nccRCC biology.
Main Methods:
- Literature review of molecular and clinical data for nccRCC subtypes.
- Analysis of current treatment strategies and their limitations in nccRCC.
- Examination of ongoing research for novel nccRCC agents.
Main Results:
- nccRCC subtypes exhibit varied molecular profiles, often unrelated to the von Hippel-Lindau (VHL) gene.
- Existing VEGF and mTOR inhibitors demonstrate limited clinical efficacy across nccRCC histologies.
- There is a significant unmet need for subtype-specific therapeutic approaches in nccRCC.
Conclusions:
- Developing targeted therapies for each nccRCC subtype is crucial.
- Future research should focus on the unique biology of non-clear cell histologies.
- Rational therapeutic strategies are needed to improve outcomes for nccRCC patients.
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