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Biological Research and Disease Studies / Cancer, Hypoxia, and Metabolism / Renal Cell Carcinoma Treatment · Journal article
World Advances in Renal Medicine · August 10, 2026
A consensus or society position rather than new primary data.
This is a narrative review synthesizing current knowledge of RCC molecular pathways (VHL–HIF–VEGF, mTOR, MET) and treatment strategies, including immunotherapy and emerging HIF-2α inhibitors. It identifies persistent clinical challenges (drug resistance, biomarker gaps) and advocates for integration of molecular insights into clinical practice but does not report original evidence or quantify treatment efficacy.
Journal article. Patients with renal cell carcinoma, including early-stage and advanced or metastatic disease.
VHL–HIF–VEGF pathway is central to tumor angiogenesis, particularly in clear cell RCC Combination of immunotherapy with targeted agents has become standard in many treatment settings HIF-2α inhibitors like belzutifan identified as promising precision treatments in tumors with VHL mutations
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
Clinicians should view this as an expert synthesis supporting current practice of combining immunotherapy with targeted therapy, and consider HIF-2α inhibitors as emerging precision options in VHL-mutant tumors. However, the review does not provide quantified efficacy data or comparative outcome evidence to guide individual treatment decisions.
A narrative review synthesizing molecular mechanisms and treatment strategies in RCC, offering expert perspective on current and emerging approaches rather than reporting original research findings.
Clinicians should view this as an expert synthesis supporting current practice of combining immunotherapy with targeted therapy, and consider HIF-2α inhibitors as emerging precision options in VHL-mutant tumors. However, the review does not provide quantified efficacy data or comparative outcome evidence to guide individual treatment decisions.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
What is missing. This record has no reported figures. That is a gap in the analysis, not a judgement about the study.
Renal cell carcinoma (RCC) poses a persistent clinical challenge, mainly due to its resistance to conventional therapies. With increased detection through modern imaging, more cases are being identified early, yet advanced or metastatic RCC remains challenging to treat. A deeper understanding of RCC’s molecular underpinnings has reshaped treatment strategies. Central to this is the von Hippel-Lindau (VHL) – hypoxia-inducible factor (HIF) – vascular endothelial growth factor pathway, which drives tumor angiogenesis, particularly in clear cell RCC. Disruption of this axis has been crucial in designing targeted therapies. In addition, pathways such as mammalian target of rapamycin and metformin (MET) play important roles in tumor growth and progression in certain subtypes. Immunotherapy has also redefined outcomes, especially with the success of immune checkpoint inhibitors, which help the body’s immune system recognize and fight cancer cells. Combining immunotherapy with targeted agents has become standard in many treatment settings due to their complementary effects. However, challenges remain – such as drug resistance and a lack of reliable biomarkers to guide therapy choices. Recently, HIF-2α inhibitors like belzutifan have emerged as promising precision treatments, especially in tumors with VHL mutations. As research continues, integrating molecular insights with clinical practice holds the potential to improve survival and quality of life for patients living with RCC.
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