Metastatic Renal Cell Carcinoma

1. Disease Information

1.1 Overview / definition

Metastatic renal cell carcinoma (mRCC) refers to renal cell carcinoma that has spread beyond the kidney to distant organs (stage IV disease), typically requiring systemic therapy and multidisciplinary management; it remains “mainly treated palliatively” despite major therapeutic advances. (ivanyi2024thetreatmentof pages 1-2)

A clinically important modern framing is that mRCC treatment is dominated by immune checkpoint inhibitor (ICI) combinations (ICI–ICI or ICI–TKI), with additional local therapies (e.g., cytoreductive nephrectomy, metastasectomy, radiotherapy) considered case-by-case by a multidisciplinary tumor board. (ivanyi2024thetreatmentof pages 1-2, bloise2024firstlinetreatmentsand pages 2-4)

Primary histology context: RCC encompasses many subtypes; a 2024 review notes the WHO classification includes 39 RCC subtypes, and clear-cell RCC is the most common (~80%). (ivanyi2024thetreatmentof pages 1-2)

Abstract quote (definition/setting): “in 20–30% of cases, metastatic RCC (mRCC) is already present at the time of diagnosis. This disease in the metastatic stage is still mainly treated palliatively…” (ivanyi2024thetreatmentof pages 1-2)

1.2 Key identifiers / coding systems

Within retrieved evidence, explicit ICD-10/ICD-11, MeSH, Orphanet, or OMIM identifiers for the metastatic entity were not present. OpenTargets returned disease IDs for broader RCC entities (e.g., EFO_0000681 “renal cell carcinoma”, EFO_0005708 “renal cell adenocarcinoma”). (OpenTargets Search: renal cell carcinoma)

1.3 Synonyms / alternative names

Commonly used equivalents in the retrieved literature include: - “advanced renal cell carcinoma” (aRCC) (powles2024nivolumabpluscabozantinib pages 1-2, yanagisawa2024updatedsystematicreview pages 4-4) - “advanced or metastatic renal cell carcinoma” (powles2024nivolumabpluscabozantinib pages 1-2) - “metastatic clear cell RCC (mccRCC)” (meng2023emergingimmunotherapyapproaches pages 5-6)

1.4 Evidence source types

This report integrates: - Aggregated disease-level resources and reviews (systematic reviews/meta-analyses; guideline-focused reviews) (yanagisawa2024updatedsystematicreview pages 4-4, ivanyi2024thetreatmentof pages 1-2) - Randomized phase III trials and updates (CheckMate 9ER, CLEAR, COSMIC-313) (powles2024nivolumabpluscabozantinib pages 1-2, choueiri2023cabozantinibplusnivolumab pages 1-3, yanagisawa2024updatedsystematicreview pages 4-4) - Regulatory evidence (FDA approval summary for belzutifan) (fallah2024fdaapprovalsummary pages 1-3) - Real-world observational cohorts (metastatic site frequencies; real-world survival) (lee2024sitesofmetastasis pages 1-2, almansour2024realworldsurvivaloutcomes pages 1-2) - Single-cell translational studies (bone-metastatic microenvironment) (ma2024singlecellprofilingof pages 1-2)

2. Etiology

2.1 Disease causal factors (mechanistic)

Clear-cell RCC is strongly linked to dysregulation of hypoxia/angiogenesis programs (VHL–HIF signaling), which underlies the historic and current success of anti-angiogenic therapy and the newer HIF-2α inhibitor class. (OpenTargets Search: renal cell carcinoma, fallah2024fdaapprovalsummary pages 1-3)

OpenTargets disease–target associations highlight canonical RCC genes/targets (e.g., VHL, PBRM1, TP53, MET, MTOR) associated with renal cell carcinoma/adenocarcinoma. (OpenTargets Search: renal cell carcinoma)

2.2 Risk factors (recent quantitative data)

Although these risk-factor studies are not restricted to metastatic disease, they inform upstream RCC incidence (and therefore mRCC burden).

Metabolic syndrome and components (UK Biobank, 2024): - Cohort: 355,678 participants, median follow-up 11 years, 1,203 kidney cancer cases. (wang2024associationbetweenmetabolic pages 1-2) - Risk vs metabolically healthy: - pre-MetS HR 1.36 (95% CI 1.06–1.74) (wang2024associationbetweenmetabolic pages 1-2) - MetS HR 1.70 (95% CI 1.30–2.23) (wang2024associationbetweenmetabolic pages 1-2) - Highest-risk component pattern reported: BP + HDL + WC HR 3.03 (95% CI 1.91–4.80). (wang2024associationbetweenmetabolic pages 5-6) - Joint effect with genetics: MetS + high polygenic risk score (PRS) HR 1.74 (95% CI 1.41–2.14) vs non‑MetS + low PRS, suggesting combined contribution of metabolic and inherited susceptibility. (wang2024associationbetweenmetabolic pages 1-2, wang2024associationbetweenmetabolic pages 5-6)

Dietary pattern (ultra-processed foods; PLCO cohort, 2024): - Cohort: ~101,688 participants; 410 RCC cases over 899,731 person-years (median follow-up 9.41 years) and 230 RCC deaths over 1,533,930 person-years (median follow-up 16.85 years). (li2024ultraprocessedfoodconsumption pages 1-2) - Highest vs lowest quartile of ultra-processed food consumption: - RCC incidence HR 1.42 (95% CI 1.06–1.91) (li2024ultraprocessedfoodconsumption pages 1-2) - RCC mortality HR 1.64 (95% CI 1.10–2.43) (li2024ultraprocessedfoodconsumption pages 1-2)

Air pollution (systematic review/meta-analysis, 2024; search through March 23, 2023): - Per 10 µg/m³ increase: - PM10 HR 1.29 (95% CI 1.10–1.51) (dahman2024airpollutionand pages 1-3) - NO2 HR 1.10 (95% CI 1.03–1.18) (dahman2024airpollutionand pages 1-3)

2.3 Protective factors

No specific protective factors with effect sizes were identified in the retrieved texts.

2.4 Gene–environment interactions

The UK Biobank analysis explicitly evaluated combined MetS and genetic risk. It reported that MetS plus high PRS conferred higher kidney cancer risk (HR 1.74, 95% CI 1.41–2.14), consistent with a joint contribution of metabolic exposures and polygenic risk to kidney cancer incidence. (wang2024associationbetweenmetabolic pages 1-2, wang2024associationbetweenmetabolic pages 5-6)

3. Phenotypes (clinical presentation)

Note: The retrieved evidence set is treatment- and outcomes-focused and contains limited structured symptom/lab phenotype frequencies for mRCC. Below is a minimal phenotype set consistent with clinical context, plus ontology suggestions.

3.1 Common clinical features (limited evidence in retrieved texts)

A 2024 review notes that only ~20% of RCC patients have “typical symptoms” at presentation (implying many are asymptomatic until advanced). (ivanyi2024thetreatmentof pages 1-2)

3.2 Suggested phenotype ontology mappings (HPO suggestions)

(These are ontology suggestions for knowledge-base structuring; frequencies were not extractable from retrieved sources.) - Hematuria — HP:0000790 - Flank pain — HP:0030765 - Abdominal mass — HP:0003278 - Weight loss — HP:0001824 - Fatigue — HP:0012378 - Anemia (common on therapy and in advanced disease) — HP:0001903 - Bone pain (bone metastasis) — HP:0002653 - Dyspnea (lung metastasis or treatment toxicity) — HP:0002094

3.3 Quality of life impact

Not directly quantified in retrieved texts; however, mRCC therapy is associated with high adverse-event burdens (e.g., grade ≥3 AEs) which plausibly affects QoL. (powles2024nivolumabpluscabozantinib pages 1-2, choueiri2023cabozantinibplusnivolumab pages 1-3, fallah2024fdaapprovalsummary pages 1-3)

4. Genetic / Molecular Information

4.1 Key genes (somatic drivers and hereditary predisposition; from OpenTargets)

OpenTargets RCC associations include genes central to RCC biology and hereditary syndromes, including VHL, PBRM1, FLCN, MET, MTOR, SETD2, KDM5C, TFE3, and BAP1 (depending on RCC subtype mapping in OpenTargets). (OpenTargets Search: renal cell carcinoma)

Ontology suggestions: - HGNC symbols: VHL, PBRM1, BAP1, SETD2, MTOR, MET

4.2 Pathways (mechanistic anchors)

• Hypoxia signaling / HIF-2α axis (targeted by belzutifan) (fallah2024fdaapprovalsummary pages 1-3)
• Angiogenesis (VEGF pathway; inferred from clinical efficacy of VEGFR-TKI combinations in first-line trials) (powles2024nivolumabpluscabozantinib pages 1-2, yanagisawa2024updatedsystematicreview pages 4-4)
• Immune evasion / immune checkpoint pathways (PD-1/PD-L1, CTLA-4 targeted by nivolumab, pembrolizumab, ipilimumab) (powles2024nivolumabpluscabozantinib pages 1-2, choueiri2023cabozantinibplusnivolumab pages 1-3, yanagisawa2024updatedsystematicreview pages 4-4)

GO suggestions (biological process): - Angiogenesis — GO:0001525 - Response to hypoxia — GO:0001666 - T cell activation — GO:0042110

5. Mechanism / Pathophysiology (metastasis and treatment response)

5.1 Metastatic niche and immune microenvironment (single-cell evidence; 2024)

A 2024 single-cell study of bone metastatic RCC profiled 6 primary and 9 bone metastatic tumors from 14 ccRCC patients, reporting extensive immune dysfunction in bone metastases and a macrophage/MDSC axis. (ma2024singlecellprofilingof pages 1-2)

Key quantitative/biological statements from the excerpt include: - “More than one-third of metastatic RCC patients were accompanied by bone metastases.” (ma2024singlecellprofilingof pages 1-2) - “The progression-free survival of BMRCC remains low of 4.7 months versus 11.2 months for those without bone metastases.” (ma2024singlecellprofilingof pages 1-2) - Bone metastatic tumors show “multifaceted immune deficiency” with macrophages exhibiting “malignant and pro-angiogenic features,” dominance of “immune inhibitory T cells,” and MDSCs as macrophage progenitors. (ma2024singlecellprofilingof pages 1-2)

Cell Ontology (CL) suggestions (key cell types): - CD8-positive, alpha-beta T cell — CL:0000625 - Regulatory T cell — CL:0000815 - Macrophage — CL:0000235 - Myeloid-derived suppressor cell — CL:0000867 - Cancer-associated fibroblast — (no single CL term universally used; often modeled as fibroblast CL:0000057 with “activated” state)

5.2 Treatment response/resistance conceptual model

mRCC outcomes reflect interplay between: - Angiogenesis dependence (TKI sensitivity) - Immune microenvironment state (ICI sensitivity) - Organ-specific niches (e.g., bone metastasis immune suppression) - Emerging targeting of HIF-2α as an upstream axis in clear-cell RCC biology. (powles2024nivolumabpluscabozantinib pages 1-2, yanagisawa2024updatedsystematicreview pages 4-4, ma2024singlecellprofilingof pages 1-2, fallah2024fdaapprovalsummary pages 1-3)

6. Anatomical Structures Affected

6.1 Common metastatic sites (frequency; 2024 multicenter cohort)

A large Korean multicenter database study (n=1,761) reported the most common metastatic sites at mRCC diagnosis: lung 70.9%, lymph nodes 37.9%, bone 30.7%, liver 12.7%, adrenal gland 9.8%, brain 8.2%. (lee2024sitesofmetastasis pages 1-2)

Median cancer-specific survival (CSS) varied by site, ranging from 13.9 months (liver) to 29.1 months (lung) among common sites (>5%); liver, bone, and pleural metastases were associated with the shortest median CSS (<19 months). (lee2024sitesofmetastasis pages 1-2)

UBERON suggestions: - Kidney — UBERON:0002113 - Lung — UBERON:0002048 - Bone — UBERON:0002481 - Liver — UBERON:0002107 - Brain — UBERON:0000955 - Adrenal gland — UBERON:0002369

7. Inheritance and Population (Epidemiology and Prognosis)

7.1 Incidence / demographics (examples from retrieved evidence)

A 2024 German review reports ~15,000 RCC diagnoses annually in Germany and notes that 20–30% present with metastatic disease at diagnosis. (ivanyi2024thetreatmentof pages 1-2)

A real-world Saudi cohort paper provides global framing figures (not limited to mRCC): “nearly 431,000 new RCC cases in 2022 with ~180,000 deaths,” and states ~35% of RCC patients present with unresectable/metastatic disease at diagnosis. (almansour2024realworldsurvivaloutcomes pages 1-2)

7.2 Prognosis and risk stratification

A 2024 review summarizes outcomes achievable with prognosis-based sequential systemic therapy: mean PFS 12–24 months and OS ≈50 months from first-line initiation. (ivanyi2024thetreatmentof pages 1-2)

IMDC risk group survivals reported in that review: low-risk 43.2 months, intermediate 22.5 months, high-risk 7.8 months. (ivanyi2024thetreatmentof pages 1-2)

8. Diagnostics

8.1 Standard diagnostic modalities (high-level)

The retrieved evidence emphasizes systemic-therapy management and does not provide a detailed diagnostic algorithm. In practice, mRCC diagnosis/staging relies on cross-sectional imaging (CT/MRI), histopathology, and risk stratification (IMDC). (ivanyi2024thetreatmentof pages 1-2)

8.2 Biomarkers and liquid biopsy (ctDNA) — recent evidence (2024)

In resected RCC (localized/high-risk), tumor-informed ctDNA is emerging as a prognostic marker for recurrence (relevant to identifying patients at risk of progression to metastatic disease).

A 2024 study using a personalized ctDNA assay (Signatera RUO) reported: - Pre-operative ctDNA detection in 18/36 (50%) patients. (correa2024associationofcirculating pages 1-2) - ctDNA positivity associated with inferior relapse-free survival (pre-op HR 2.70, P=0.046; post-op/any time HR 3.23, P=0.003). (correa2024associationofcirculating pages 1-2) - Relapse prediction performance among ctDNA-positive patients: sensitivity 84%, PPV 90%; post-surgical ctDNA positivity PPV 100%; NPV 64%; absence at both timepoints NPV 80%. (correa2024associationofcirculating pages 1-2)

Abstract quote (key point): “Detection of plasma ctDNA using a personalized assay is prognostic of recurrence in patients with resected RCC.” (correa2024associationofcirculating pages 1-2)

9. Treatment (current applications and real-world implementations)

9.1 Current first-line systemic therapy landscape (2023–2024 high-quality sources)

Contemporary 1L mRCC therapy is dominated by ICI-based combinations (IO/TKI or IO/IO). A 2024 review states: “mRCC can be treated with a combination of two immune checkpoint inhibitors (CPIs), a CPI and a tyrosine-kinase inhibitor (TKI) (evidence level IA), or a TKI as monotherapy…” (ivanyi2024thetreatmentof pages 1-2)

A 2024 network meta-analysis excerpt provides comparative phase III outcomes across major 1L regimens versus sunitinib (PFS, OS, ORR, CR rates), reinforcing that multiple regimens improve outcomes with different tradeoffs (e.g., higher PFS/ORR with IO/TKI vs durability with IO/IO). (yanagisawa2024updatedsystematicreview pages 4-4)

9.2 Key pivotal trials and updates (artifact)

The following table summarizes major 2023–2024 trial evidence and regulatory developments.

Table: This table summarizes key 2023-2024 systemic therapy evidence in metastatic or advanced renal cell carcinoma, including pivotal first-line and later-line studies. It highlights efficacy, safety, and publication details for quick comparison across major regimens.

9.3 Later-line therapy: HIF-2α inhibition (belzutifan)

FDA granted traditional approval (Dec 14, 2023) for belzutifan in advanced RCC after prior PD-(L)1 inhibitor and VEGF-TKI, based on LITESPARK-005 demonstrating PFS benefit vs everolimus (HR 0.75, 95% CI 0.63–0.90) and ORR 22% vs 3.6%. (fallah2024fdaapprovalsummary pages 1-3)

9.4 Real-world implementation examples

A 2024 retrospective real-world cohort of metastatic clear-cell RCC (n=84) reported median first-line PFS 9.7 months and median OS 42.0 months, with ORR 41% for ICI-based combinations (in that cohort) and identified liver metastasis and lower performance status as adverse prognostic factors. (almansour2024realworldsurvivaloutcomes pages 1-2)

9.5 Local therapies in metastatic disease

A 2024 algorithm-focused review emphasizes multidisciplinary selection of cytoreductive nephrectomy and metastasectomy; it reports trial/observational signals that delayed nephrectomy strategies and complete metastasectomy can improve OS in selected patients (e.g., SURTIME mOS 32.5 vs 15 months; complete metastasectomy mOS 40.7 vs 14.8 months in the cited context). (bloise2024firstlinetreatmentsand pages 2-4)

9.6 MAXO suggestions (treatment actions)

• Immune checkpoint inhibitor therapy — MAXO:0000647 (suggested)
• Tyrosine kinase inhibitor therapy — MAXO:0000704 (suggested)
• Nephrectomy — MAXO:0000897 (suggested)
• Metastasectomy — MAXO:0000934 (suggested)
• Radiation therapy — MAXO:0000014 (suggested)

10. Prevention

10.1 Primary prevention (risk reduction)

Recent epidemiologic evidence supports risk reduction focusing on metabolic health, diet patterns, and environmental exposures: - Metabolic syndrome and combinations of metabolic abnormalities are associated with increased kidney cancer risk (e.g., MetS HR 1.70, BP+HDL+WC HR 3.03). (wang2024associationbetweenmetabolic pages 1-2, wang2024associationbetweenmetabolic pages 5-6) - Higher ultra-processed food intake is associated with higher RCC incidence and mortality (HR 1.42 and 1.64 for highest vs lowest quartile). (li2024ultraprocessedfoodconsumption pages 1-2) - Air pollution exposures PM10 and NO2 show positive associations with kidney cancer incidence in meta-analysis (PM10 HR 1.29; NO2 HR 1.10 per 10 µg/m³). (dahman2024airpollutionand pages 1-3)

10.2 Secondary prevention / surveillance

No surveillance guideline text for hereditary RCC syndromes was retrieved in the current evidence set.

11. Other Species / Natural Disease

Not addressed in the retrieved evidence set.

12. Model Organisms

Not addressed in the retrieved evidence set (no murine/xenograft/organoid model papers were retrieved).

13. Key Statistics (quick reference)

• Metastatic at diagnosis: 20–30% (Germany review) (ivanyi2024thetreatmentof pages 1-2)
• Common metastatic sites and frequencies: lung 70.9%, LN 37.9%, bone 30.7%, liver 12.7%, adrenal 9.8%, brain 8.2% (Korean cohort, n=1,761) (lee2024sitesofmetastasis pages 1-2)
• IMDC median survivals: favorable 43.2 mo; intermediate 22.5 mo; poor 7.8 mo (review) (ivanyi2024thetreatmentof pages 1-2)
• CheckMate 9ER (44 mo follow-up): median OS 49.5 vs 35.5 mo; median PFS 16.6 vs 8.4 mo (nivolumab+cabozantinib vs sunitinib) (powles2024nivolumabpluscabozantinib pages 1-2)
• CLEAR final OS analysis: OS HR 0.79; median PFS 23.9 vs 9.2 mo; ORR 71.3% vs 36.7% (lenvatinib+pembrolizumab vs sunitinib) (yanagisawa2024updatedsystematicreview pages 4-4)
• Belzutifan (LITESPARK-005): PFS HR 0.75; ORR 22% vs 3.6% vs everolimus (fallah2024fdaapprovalsummary pages 1-3)

Limitations of the retrieved evidence set (transparency)

• Explicit ontology identifiers (ICD-10/ICD-11, MeSH, Orphanet, dedicated MONDO for metastatic RCC) were not present in retrieved texts and thus could not be verified here. (OpenTargets Search: renal cell carcinoma)
• Detailed phenotype frequencies (symptoms/labs) and hereditary-syndrome surveillance guidance were not captured in the available evidence snippets.
• Model organism and comparative oncology coverage was not available from retrieved sources.

References

1. (OpenTargets Search: renal cell carcinoma): Open Targets Query (renal cell carcinoma, 48 results). Buniello, A. et al. (2025). Open Targets Platform: facilitating therapeutic hypotheses building in drug discovery. Nucleic Acids Research.

2. (ivanyi2024thetreatmentof pages 1-2): Philipp Ivanyi, Tabea Fröhlich, Viktor Grünwald, Stefanie Zschäbitz, Jens Bedke, and Christian Doehn. The treatment of metastatic renal cell carcinoma. Deutsches Arzteblatt international, Aug 2024. URL: https://doi.org/10.3238/arztebl.m2024.0147, doi:10.3238/arztebl.m2024.0147. This article has 19 citations and is from a peer-reviewed journal.

3. (bloise2024firstlinetreatmentsand pages 2-4): Francesco Bloise, Fiorella Manfredi, Luca Zatteri, Giovanni Dima, Chiara Carli, Rosanna Di Vita, Maria Olivieri, Enrico Sammarco, Marco Ferrari, Alessia Salfi, Adele Bonato, Debora Serafin, Natalia Coccia, Laura Doni, Luca Galli, Michele Sisani, Giandomenico Roviello, Martina Catalano, and Federico Paolieri. First-line treatments and management of metastatic renal cell carcinoma patients: an italian interdisciplinary uro-oncologic group algorithm. Cells, 13:961, Jun 2024. URL: https://doi.org/10.3390/cells13110961, doi:10.3390/cells13110961. This article has 3 citations.

4. (powles2024nivolumabpluscabozantinib pages 1-2): T. Powles, M. Burotto, B. Escudier, A. Apolo, M. Bourlon, A. Shah, C. Suárez, C. Porta, C. Barrios, M. Richardet, H. Gurney, E. R. Kessler, Y. Tomita, J. Bedke, S. George, C. Scheffold, P. Wang, V. Fedorov, R. Motzer, T. Choueiri, and Prof. Thomas Powles. Nivolumab plus cabozantinib versus sunitinib for first-line treatment of advanced renal cell carcinoma: extended follow-up from the phase iii randomised checkmate 9er trial. ESMO Open, 9:102994, May 2024. URL: https://doi.org/10.1016/j.esmoop.2024.102994, doi:10.1016/j.esmoop.2024.102994. This article has 105 citations and is from a domain leading peer-reviewed journal.

5. (yanagisawa2024updatedsystematicreview pages 4-4): Takafumi Yanagisawa, Keiichiro Mori, Akihiro Matsukawa, Tatsushi Kawada, Satoshi Katayama, Kensuke Bekku, Ekaterina Laukhtina, Pawel Rajwa, Fahad Quhal, Benjamin Pradere, Wataru Fukuokaya, Kosuke Iwatani, Masaya Murakami, Karim Bensalah, Viktor Grünwald, Manuela Schmidinger, Shahrokh F. Shariat, and Takahiro Kimura. Updated systematic review and network meta-analysis of first-line treatments for metastatic renal cell carcinoma with extended follow-up data. Cancer Immunology, Immunotherapy : CII, Jan 2024. URL: https://doi.org/10.1007/s00262-023-03621-1, doi:10.1007/s00262-023-03621-1. This article has 38 citations.

6. (meng2023emergingimmunotherapyapproaches pages 5-6): Lingbin Meng, Katharine A. Collier, Peng Wang, Zihai Li, Paul Monk, Amir Mortazavi, Zhiwei Hu, Daniel Spakowicz, Linghua Zheng, and Yuanquan Yang. Emerging immunotherapy approaches for advanced clear cell renal cell carcinoma. Cells, 13:34, Dec 2023. URL: https://doi.org/10.3390/cells13010034, doi:10.3390/cells13010034. This article has 72 citations.

7. (choueiri2023cabozantinibplusnivolumab pages 1-3): Toni K. Choueiri, Thomas Powles, Laurence Albiges, Mauricio Burotto, Cezary Szczylik, Bogdan Zurawski, Eduardo Yanez Ruiz, Marco Maruzzo, Alberto Suarez Zaizar, Luis E. Fein, Fabio A. Schutz, Daniel Y.C. Heng, Fong Wang, Fabio Mataveli, Yu-Lin Chang, Maximiliano van Kooten Losio, Cristina Suarez, and Robert J. Motzer. Cabozantinib plus nivolumab and ipilimumab in renal-cell carcinoma. The New England journal of medicine, 388 19:1767-1778, May 2023. URL: https://doi.org/10.1056/nejmoa2212851, doi:10.1056/nejmoa2212851. This article has 188 citations and is from a highest quality peer-reviewed journal.

8. (fallah2024fdaapprovalsummary pages 1-3): Jaleh Fallah, Brian L. Heiss, Hee-Koung Joeng, Chana Weinstock, Xin Gao, William F. Pierce, Benjamin Chukwurah, Vishal Bhatnagar, Mallorie H. Fiero, Laleh Amiri-Kordestani, Richard Pazdur, Paul G. Kluetz, and Daniel L. Suzman. Fda approval summary: belzutifan for patients with advanced renal cell carcinoma. Clinical cancer research : an official journal of the American Association for Cancer Research, 30:5003-5008, Sep 2024. URL: https://doi.org/10.1158/1078-0432.ccr-24-1199, doi:10.1158/1078-0432.ccr-24-1199. This article has 23 citations.

9. (lee2024sitesofmetastasis pages 1-2): Chan Ho Lee, Minyong Kang, Cheol Kwak, Young Hwii Ko, Jung Kwon Kim, Jae Young Park, Seokhwan Bang, Seong Il Seo, Jungyo Suh, Wan Song, Cheryn Song, Hyung Ho Lee, Jinsoo Chung, Chang Wook Jeong, Jung Ki Jo, Seock Hwan Choi, Joongwon Choi, Changil Choi, Seol Ho Choo, Jang Hee Han, Sung-Hoo Hong, and Eu Chang Hwang. Sites of metastasis and survival in metastatic renal cell carcinoma: results from the korean renal cancer study group database. Journal of Korean Medical Science, Sep 2024. URL: https://doi.org/10.3346/jkms.2024.39.e293, doi:10.3346/jkms.2024.39.e293. This article has 19 citations and is from a peer-reviewed journal.

10. (almansour2024realworldsurvivaloutcomes pages 1-2): Mubarak M. Al-Mansour, Syed Sameer Aga, Hanin A. Alharbi, Maria N. Alsulami, Halah A. Fallatah, Tarfah B. Albedaiwi, Lujain K. Anbari, Taleen R. Surrati, Ashwag A. Algethami, Alaa Althubaiti, Turki M. Alfayea, and Ashwaq Alolayan. Real-world survival outcomes of first-line therapies in patients with metastatic clear cell renal cell carcinoma: a retrospective analysis from two centres in saudi arabia. Cancers, 16:3234, Sep 2024. URL: https://doi.org/10.3390/cancers16183234, doi:10.3390/cancers16183234. This article has 2 citations.

11. (ma2024singlecellprofilingof pages 1-2): Fen Ma, Shuoer Wang, Lun Xu, Wending Huang, Guohai Shi, Zhengwang Sun, Weiluo Cai, Zhiqiang Wu, Yiming Huang, Juan Meng, Yining Sun, Meng Fang, Mo Cheng, Yingzheng Ji, Tu Hu, Yunkui Zhang, Bingxin Gu, Jiwei Zhang, Shaoli Song, Yidi Sun, and Wangjun Yan. Single-cell profiling of the microenvironment in human bone metastatic renal cell carcinoma. Communications Biology, Jan 2024. URL: https://doi.org/10.1038/s42003-024-05772-y, doi:10.1038/s42003-024-05772-y. This article has 12 citations and is from a peer-reviewed journal.

12. (wang2024associationbetweenmetabolic pages 1-2): Lin Wang, Han Du, Chao Sheng, Hongji Dai, and Kexin Chen. Association between metabolic syndrome and kidney cancer risk: a prospective cohort study. Lipids in Health and Disease, May 2024. URL: https://doi.org/10.1186/s12944-024-02138-5, doi:10.1186/s12944-024-02138-5. This article has 12 citations and is from a peer-reviewed journal.

13. (wang2024associationbetweenmetabolic pages 5-6): Lin Wang, Han Du, Chao Sheng, Hongji Dai, and Kexin Chen. Association between metabolic syndrome and kidney cancer risk: a prospective cohort study. Lipids in Health and Disease, May 2024. URL: https://doi.org/10.1186/s12944-024-02138-5, doi:10.1186/s12944-024-02138-5. This article has 12 citations and is from a peer-reviewed journal.

14. (li2024ultraprocessedfoodconsumption pages 1-2): Ya-Dong Li, Yong-Xin Fu, Le-Lan Gong, Ting Xie, Wei Tan, Hao Huang, Sheng-Jie Zeng, Chuan Liu, and Zheng-Ju Ren. Ultra-processed food consumption and renal cell carcinoma incidence and mortality: results from a large prospective cohort. BMC Medicine, Oct 2024. URL: https://doi.org/10.1186/s12916-024-03677-5, doi:10.1186/s12916-024-03677-5. This article has 9 citations and is from a domain leading peer-reviewed journal.

15. (dahman2024airpollutionand pages 1-3): Lina Dahman, Victoria Gauthier, Aurore Camier, Jean Joel Bigna, François Glowacki, Philippe Amouyel, Luc Dauchet, and Aghiles Hamroun. Air pollution and kidney cancer risk: a systematic review and meta-analysis. Journal of Nephrology, 37:1779-1790, Jun 2024. URL: https://doi.org/10.1007/s40620-024-01984-x, doi:10.1007/s40620-024-01984-x. This article has 16 citations and is from a peer-reviewed journal.

16. (correa2024associationofcirculating pages 1-2): Andres F Correa, Ekaterina Kalashnikova, Hsin-Ta Wu, Ryan M Winters, Mustafa Balcioglu, Sumedha Sudhaman, Denise C Connolly, Yulan Gong, Robert G Uzzo, Himanshu Sethi, Adam C ElNaggar, Alexey Aleshin, Minetta C Liu, and Philip H Abbosh. Association of circulating tumor dna with patient prognosis in surgically resected renal cell carcinoma. The Oncologist, 29:887-893, Jul 2024. URL: https://doi.org/10.1093/oncolo/oyae180, doi:10.1093/oncolo/oyae180. This article has 26 citations.