oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2025-24-4-122-133oncotomsk-3780Research ArticleОБЗОРЫREVIEWSЭтиология, эпидемиология, стратегии и причины низкой эффективности лечения светлоклеточного почечно-клеточного ракаEtiology, epidemiology, strategies and reasons of low efficiency of treatment of clear cell renal cell carcinomahttps://orcid.org/0000-0003-4897-8676ЛыковА. П.LykovA. P.

Лыков Александр Петрович, доктор медицинских наук, ведущий научный сотрудник лаборатории клеточных технологий 

Author ID (Scopus): 7005078523 

630060, г. Новосибирск, ул. Тимакова, 2 

Alexander P. Lykov, MD, DSc, Leading Researcher, Laboratory of Cell Technologies 

Author ID (Scopus): 7005078523 

2, Timakova st., Novosibirsk, 630060 

https://orcid.org/0000-0001-7933-8394АгееваТ. А.AgeevaT. A.

Агеева Татьяна Августовна, доктор медицинских наук, профессор кафедры патологической анатомии 

Author ID (Scopus): 57092064200 

630091, г. Новосибирск, ул. Красный пр-т, 52 

Tatyana A. Ageeva, MD, DSc, Professor, Department of Pathological Anatomy 

Author ID (Scopus): 57092064200 

52, Krasnyi prospect, Novosibirsk, 630091

ageta@mail.ruhttps://orcid.org/0000-0002-9521-2641СеляковаМ. С.SelyakovaM. S.

Селякова Мария Сергеевна, кандидат медицинских наук, старший преподаватель кафедры патологической анатомии 

Author ID (Scopus): 5720410477 

630091, г. Новосибирск, ул. Красный пр-т, 52 

Maria S. Selyakova, MD, PhD, Senior Lecturer, Department of Pathological Anatomy 

Author ID (Scopus): 5720410477 

52, Krasnyi prospect, Novosibirsk, 630091 

НИИКЭЛ – филиал ИЦиГ СО РАНРоссияRICEL – Branch of IC&G SB RSARussian FederationФГБОУ ВО «Новосибирский государственный медицинский университет» Минздрава РоссииРоссияNovosibirsk State Medical University, Ministry of Health of RussiaRussian Federation202501102025244122133Copyright © Лыков А.П., Агеева Т.А., Селякова М.С., 20252025Лыков А.П., Агеева Т.А., Селякова М.С.Lykov A.P., Ageeva T.A., Selyakova M.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/3780

Актуальность. В основе возникновения почечно-клеточного рака (ПКР), в том числе и светлоклеточного почечно-клеточного рака (сПКР), лежат различные генетические изменения, которые на данный момент не поддаются корректировке. Этот факт делает актуальным изучение генетического профиля сПКР и биомолекул, вовлеченных в реализацию генетических изменений, что может стать основой для разработки таргетных терапевтических стратегий. Цель исследования – проанализировать и обобщить научную литературу, описывающую современные стратегии терапевтических подходов в лечении ПКР и причины низкой эффективности биологических методов лечения. Материал и методы. Проанализированы результаты поиска по научной базе данных PubMed и научной электронной библиотеке elibrary.ru по следующим ключевым словосочетаниям: renal cell carcinoma (ПКР), clear cell renal cell carcinoma (сПКР), molecular biomarkers and clear cell renal cell carcinoma (молекулярные биомаркеры и сПКР), multi-omic profiling and renal cell cancer (мультиомиксный профиль и ПКР), signaling pathway and renal cell carcinoma (сигнальные пути и ПКР), stem cell subtypes and clear cell renal cell carcinoma (стволовые клетки и сПКР), treatment strategies and renal cell carcinoma (терапевтические стратегии и ПКР), в качестве основных справочных источников взяты обзоры и оригинальные исследования, в основном публикации за 2020–25 гг. по каждой тематической области. Статьи, содержащие дублирующуюся или значительно перекрывающуюся информацию, были исключены. Отобрано 79 актуальных публикаций зарубежных и отечественных авторов за период с 2020 по 2025 г. Результаты. Наиболее изученными генетическими изменениями при ПРК, в том числе и при сПКР, являются гены-супрессоры VHL и BAP1. Среди терапевтических стратегий применяются различные ингибиторы тирозинкиназ и ключевых точек иммунитета, также продолжается поиск новых точек (гены, сигнальные молекулы, белки) как потенциальных стратегий новых терапевтических подходов. Заключение. В патогенезе ПКР, в том числе и сПКР, существенная роль принадлежит геномным нарушениям, при выборе тактики терапевтической стратегии лечения больных ПКР следует ориентироваться на результаты эффективности биологических методов лечения, по данным ретроспективных исследований, а также на эффективность лечения иммунного микроокружения опухоли, экспрессии на поверхности опухолевых клеток молекул, способных снижать действие лекарственных препаратов.

Objective.  Numerous genetic alterations that are currently incurable are the cause of renal cell carcinoma (RCC), including clear cell renal cell carcinoma (ccRCC). studying the genetic profile of ccRCC and biomolecules involved in the execution of genetic modifications is pertinent because of this fact, as it may serve as the foundation for the creation of targeted therapeutic approaches. The aim of the study was to analyze and summarize the most recent scientific literature outlining contemporary therapy options for RCC treatment as well as the causes of the low efficacy of biological treatment methods. Material and Methods. Key words and phrases such as renal cell carcinoma (RCC), clear cell renal cell carcinoma (ccRCC), molecular biomarkers and clear cell renal cell carcinoma, multi-omic profiling and renal cell carcinoma, signaling pathway and renal cell carcinoma, stem cell subtypes and clear cell renal cell carcinoma, treatment strategies and renal cell carcinoma were searched for and analyzed in PubMed and elibrary.ru databases from 2020 to 2025. We used reviews and original research, primarily from 2020 to 2025, as the primary reference sources for each theme area, while papers with redundant or excessively overlapping content were disregarded. From 2020 to 2025, we chose 79 pertinent works by both domestic and foreign authors. Results. The VHl and BaP1 suppressor genes are the most extensively researched genetic alterations in RCC, including ccRCC. In addition to the utilization of critical immunological points and different tyrosine kinase inhibitors, the search for new points (genes, signaling molecules, and proteins) as possible solutions for novel treatment approaches is still ongoing. Conclusion. Genomic abnormalities are considered to have an important role in the pathophysiology of RCCs, particularly ccRCC. The effectiveness of biological treatment methods based on retrospective studies, the influence of the tumor's immune microenvironment, and the expression of molecules on the tumor cell surface that can decrease the effectiveness of medications must all be taken into consideration when selecting a therapeutic approach for patients with RCCs.

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The authors declare that there are no conflicts of interest present.