The following article features coverage from the International Kidney Cancer Symposium 2021. Click here to read more of Cancer Therapy Advisor’s conference coverage.

A real-world analysis revealed distinct gene expression profiles in patients with clear cell renal cell carcinoma (ccRCC) and those with non-clear cell RCC (nccRCC). 

The findings could potentially inform personalized treatment of nccRCC, according to Pedro Barata, MD, of Tulane University in New Orleans. Dr Barata presented these findings at the International Kidney Cancer Symposium (IKCS) 2021.

Dr Barata and colleagues analyzed 657 patient samples, including 148 from patients with nccRCC. The samples were taken from the kidneys (51.7%), lungs (11.4%), bone (6.8%), lymph nodes (5.2%), liver (4.2%), and other metastatic sites (20.7%). 

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The samples were sequenced and divided into the following molecular subgroups: snoRNA, stromal/proliferative, proliferative, T-effector/proliferative, complement/Ω-oxidation, angiogenic, and angio/stromal.

When looking at the distribution of subgroups by histology, the researchers found that 50.4% of ccRCC samples were classified as angiogenic or angio/stromal. However, these subtypes accounted for less than 10% of the nccRCC samples. Instead, the most common subtype in nccRCC samples was proliferative (48.6%).

Dr Barata noted that immunosuppressive cell types were most abundant in the stromal/proliferative subtype, and endothelial cells were most abundant in the angiogenic and angio/stromal subtypes.

The T-effector/proliferative subtype was associated with a dominance of immunogenic cells, higher PD-L1 expression, and sarcomatoid/rhabdoid features. In fact, ccRCC and nccRCC samples with sarcomatoid/rhabdoid features had similar enrichment of the T-effector/proliferative subgroup.

PD-L1-positive rates were higher in nccRCC samples than in ccRCC samples. Rates of mismatch repair deficiency/high microsatellite instability and high tumor mutational burden were highest in collecting duct carcinoma and rare in the other histological subgroups. 

Dr Barata acknowledged that this analysis had its limitations, and prospective validation is needed, but he said these findings provide a new understanding of nccRCC that may have implications for treatment.

Disclosures: Dr Barata disclosed affiliations with Astellas, Eisai, Janssen, EMD Serono, Dendreon, Pfizer, Seattle Genetics, Bristol Myers Squibb, Bayer, Guardant Health, AstraZeneca, Merck, Blue Earth Diagnostics, AVEO Oncology, and Caris.

Read more of Cancer Therapy Advisor’s coverage of IKCS 2021 by visiting the conference page.


Barata P. Gene expression profiling (GEP) of non-clear cell renal cell carcinoma (nccRCC) identifies a unique spectrum of transcriptional signatures with potential clinical relevance. Presented at IKCS 2021; November 5-6, 2021. Abstract N26.

This article originally appeared on Cancer Therapy Advisor