International Journal of Clinical Case Reports 2024, Vol.14, No.4, 189-201 http://medscipublisher.com/index.php/ijccr 199 personalized immunotherapy—tailored to individual patient profiles based on biomarkers such as tumor mutational burden (TMB) and HLA diversity—holds promise for optimizing treatment outcomes and minimizing adverse effects. Finally, further studies are needed to establish reliable predictive biomarkers for patient selection, which will help clinicians personalize therapy based on individual tumor characteristics and immune profiles. Advances in genetic and molecular profiling are expected to pave the way for more precise and effective use of immunotherapies in RCC, ultimately leading to improved patient outcomes and longer-lasting responses to treatment. Acknowledgments I would like to thank two anonymous peer reviewers for their suggestions on my manuscript. Conflict of Interest Disclosure The author affirms that this research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest. References Abou Alaiwi S., Xie W., Nassar A., Dudani S., Martini D., Bakouny Z., Steinharter J.A., Nuzzo P.V., Flippot R., Martinez-Chanza N., Wei X., McGregor B.A., Kaymakcalan M.D., Heng D.Y.C., Bilen M.A., Choueiri T.K., and Harshman L.C., 2020, Safety and efficacy of restarting immune checkpoint inhibitors after clinically significant immune-related adverse events in metastatic renal cell carcinoma, Journal for Immunotherapy of Cancer, 8(1): e000144. https://doi.org/10.1136/jitc-2019-000144 PMID: 32066646 PMCID: PMC7057439 Álvarez Ballesteros P., Chamorro J., San Román-Gil M., Pozas J., Gómez Dos Santos V., Granados A., Grande E., Alonso-Gordoa T., and Molina-Cerrillo J., 2021, Molecular mechanisms of resistance to immunotherapy and antiangiogenic treatments in clear cell renal cell carcinoma, Cancers, 13(23): 5981. https://doi.org/10.3390/cancers13235981 PMID: 34885091 PMCID: PMC8656474 Barrueto L., Caminero F., Cash L., Makris C., Lamichhane P., and Deshmukh R., 2020, Resistance to checkpoint inhibition in cancer immunotherapy, Translational Oncology, 13(3): 100738. https://doi.org/10.1016/j.tranon.2019.12.010 PMID: 32114384 PMCID: PMC7047187 Bedke J., Albiges L., Capitanio U., Giles R., Hora M., Lam T., Ljungberg B., Marconi L., Klatte T., Volpe A., Abu-Ghanem Y., Dabestani S., Fernández Pello S., Hofmann F., Kuusk T., Tahbaz R., Powles T., and Bex A., 2020, Updated european association of urology guidelines on renal cell carcinoma: nivolumab plus cabozantinib joins immune checkpoint inhibition combination therapies, European Urology, 79(3): 339-342. https://doi.org/10.1016/j.eururo.2020.12.005 PMID: 33357997 Bi K., He M.X., Bakouny Z., Kanodia A., Napolitano S., Wu J., Grimaldi G., Braun D., Cuoco M.S., Mayorga A., Dellostritto L., Bouchard G., Steinharter J., Tewari A.K., Vokes N., Shannon E., Sun M., Park J., Chang S.L., McGregor B., Haq R., Denize T., Signoretti S., Guerriero J.L., Vigneau S., Rozenblatt-Rosen O., Rotem A., Regev A., Choueiri T., and Van Allen E.V., 2021, Tumor and immune reprogramming during immunotherapy in advanced renal cell carcinoma, Cancer Cell, 39(5): 649-661. https://doi.org/10.1016/j.ccell.2021.02.015 PMID: 33711272 PMCID: PMC8115394 Budka J.A., Damayanti N., and Pili R., 2019, HDAC inhibition improves immune checkpoint inhibitor efficacy in renal cell carcinoma, Immunology, 79 (13_Supplement): 2366. https://doi.org/10.1158/1538-7445.SABCS18-2366 Byun D., Wolchok J., Rosenberg L., and Girotra M., 2017, Cancer immunotherapy - immune checkpoint blockade and associated endocrinopathies, Nature Reviews Endocrinology, 13(4): 195-207. https://doi.org/10.1038/nrendo.2016.205 PMID: 28106152 PMCID: PMC5629093 Chatwal M., Chahoud J., and Spiess P.E., 2023, Revisiting mechanisms of resistance to immunotherapies in metastatic clear-cell renal-cell carcinoma, Cancer Drug Resistance, 6: 314-326. https://doi.org/10.20517/cdr.2023.09 Chen T., 2024, Single-cell RNA sequencing reveals new insights into tumor heterogeneity, Cancer Genetics and Epigenetics, 12(1): 55-65. https://doi.org/10.5376/cge.2024.12.0007 Cui S., 2017, Immunogenic chemotherapy sensitizes renal cancer to immune checkpoint blockade therapy in preclinical models, Medical Science Monitor, 23: 3360-3366. https://doi.org/10.12659/MSM.902426 PMID: 28697172 PMCID: PMC5516681
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