Renal Cancer pp 307-323 | Cite as

Management of Non-Clear Cell Renal Cell Carcinoma

  • Jeremy A. Ross
  • Pavlos Msaouel
  • Nizar M. TannirEmail author


Renal cell carcinoma comprises a large, heterogeneous group of tumors. Although clear cell renal cancer is the most common subtype, 20–25% of renal malignancies are of variant histology. Papillary renal cell carcinoma represents the most common non-clear cell histology, with unclassified, chromophobe, translocation, collecting duct, and renal medullary carcinoma making up the majority of the remainder. With the exception of collecting duct and renal medullary carcinoma, non-clear cell renal cell carcinomas tend to be resistant to chemotherapy. Immunotherapy tends to produce less responses among non-clear cell subtypes compared with clear cell renal cell carcinomas. The limited representation of non-clear cell renal cell carcinomas in large phase III randomized trials lends to uncertainty regarding the benefit of targeted therapy in this group.

Although anti-vascular endothelial growth factor (VEGF) agents, mammalian target of rapamycin (mTOR) inhibitors, and immune checkpoint inhibitors (ICIs) have made a large impact in the management of advanced clear cell renal cell carcinoma, their efficacy in non-clear cell histologies is still being defined. As we learn more about these tumor types, new subtypes of non-clear cell kidney cancer and new genetic abnormalities are being discovered. This improved understanding can lead to better treatments in the future for our patients.


Non-clear cell renal cell carcinoma Papillary Renal medullary carcinoma Collecting duct carcinoma Translocation carcinoma Chromophobe Unclassified renal cancer Chemotherapy VEGF mTOR 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Jeremy A. Ross
    • 1
  • Pavlos Msaouel
    • 2
  • Nizar M. Tannir
    • 3
    Email author
  1. 1.Cancer Medicine, Fellowship Program, UT MD Anderson Cancer CenterHoustonUSA
  2. 2.Department of Genitourinary Medical OncologyUT MD Anderson Cancer CenterHoustonUSA
  3. 3.Genitourinary Medical Oncology, UT MD Anderson Cancer CenterHoustonUSA

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