Updates on Clinical Trials and Molecular Characteristics of Locally Advanced and Oligometastatic Renal Cell Carcinoma

Renal cell carcinoma (RCC), particularly the clear cell subtype, is a solid tumor characterized by a high degree of immune cell infiltration, progressive immune dysfunction, and favorable response to immune checkpoint inhibitors (ICIs). Dual checkpoint inhibition or single-agent ICIs with anti-angiogenic therapies have become the standard of care in the treatment of advanced and metastatic RCCs. Locally advanced and oligometastatic RCCs are distinct clinical categories that are characterized by local invasion and initially limited metastatic spread, respectively, with different therapeutic responses and prognoses compared to either localized or advanced diseases. Herein, we summarize the biology, treatment, and molecular profiling of RCCs, providing an update on the clinical trials pertaining to cancer patients with locally advanced and oligometastatic RCC. We also discuss molecular features that could contribute to a better understanding of the tumor biology driving locally advanced and oligometastatic RCC.