- Barata, Pedro;
- Gulati, Shuchi;
- Elliott, Andrew;
- Hammers, Hans;
- Burgess, Earle;
- Gartrell, Benjamin;
- Darabi, Sourat;
- Bilen, Mehmet;
- Basu, Arnab;
- Geynisman, Daniel;
- Dawson, Nancy;
- Zibelman, Matthew;
- Zhang, Tian;
- Wei, Shuanzeng;
- Ryan, Charles;
- Heath, Elisabeth;
- Poorman, Kelsey;
- Nabhan, Chadi;
- McKay, Rana
Molecular profiling of clear cell renal cell carcinoma (ccRCC) tumors of patients in a clinical trial has identified distinct transcriptomic signatures with predictive value, yet data in non-clear cell variants (nccRCC) are lacking. We examined the transcriptional profiles of RCC tumors representing key molecular pathways, from a multi-institutional, real-world patient cohort, including ccRCC and centrally reviewed nccRCC samples. ccRCC had increased angiogenesis signature scores compared with the heterogeneous group of nccRCC tumors, while cell cycle, fatty acid oxidation/AMPK signaling, and fatty acid synthesis/pentose phosphate signature scores were increased in one or more nccRCC subtypes. Among both ccRCC and nccRCC tumors, T effector scores statistically correlated with increased immune cell infiltration and were more commonly associated with immunotherapy-related markers (PD-L1+/TMBhi/MSIhi). In conclusion, this study provides evidence of differential gene transcriptional profiles among ccRCC versus nccRCC tumors, providing insights for optimizing personalized and histology-specific therapeutic strategies for patients with advanced RCC.