Etiology, epidemiology, strategies and reasons of low efficiency of treatment of clear cell renal cell carcinoma

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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