Insights into the mechanisms of drug resistance in renal cell carcinoma: from multi-omics perspective

Renal cell carcinoma (RCC) is a prevalent malignancy of the urinary system. Despite significant advances achieved through targeted therapies and immunotherapies, therapeutic resistance remains a major obstacle to sustained clinical efficacy. This review comprehensively examines the molecular mechanisms driving resistance to both targeted therapy and immunotherapy in RCC from a multi-omics perspective. By integrating findings across diverse omics layers, we underscore the pivotal role of multi-level regulatory networks in mediating drug resistance and immune evasion. Our objective is to provide an in-depth understanding of these resistance mechanisms and to establish a theoretical framework for developing innovative therapeutic strategies aimed at overcoming resistance, thereby facilitating the advancement of precision oncology in RCC.