Two decades of research on drug resistance in renal cell carcinoma

BACKGROUND: Drug resistance in renal cell carcinoma (RCC) poses a major challenge to effective treatment. RCC drug resistance is primarily driven by genetic mutations, angiogenesis, immune suppression, metabolic reprogramming, and alternative signaling pathways, which contribute to treatment failure. OBJECTIVE: This study presents a bibliometric analysis of research on drug resistance in renal cell carcinoma (RCC) from 1999 to 2023, aiming to identify key contributors, research hotspots, and future directions. METHODS: Relevant literature on renal cancer drug resistance published between 1999 and 2023 was sourced from the Web of Science Core Collection (WoSCC) database. Visual analysis was performed using VOSviewer and CiteSpace software, focusing on contributions from countries, institutions, journals, authors and keywords (such as immune checkpoint inhibitors, ICIs). RESULTS: A significant increase in research on renal cancer drug resistance has been observed in the past 20 years, based on an analysis of 4130 publications. Harvard University leads in publication output, and Motzer RJ is among the most frequently co-cited authors. The primary research topics include cancer-related clinical trials, drug efficacy assessments, molecular characteristics of tumors, immune microenvironment, and personalized treatment strategies More recent work has focused on understanding the molecular mechanisms behind drug resistance, including the dynamic tumor microenvironment (TME) and metabolic alterations, as well as the role of immune checkpoint inhibitors (ICIs). CONCLUSION: This bibliometric analysis outlines key trends and research advancements in renal cancer drug resistance over the past two decades. Although there has been substantial progress in comprehensive resistance mechanisms, further research is imperative to elucidate the molecular crosstalk within the TME and therapeutic potential of ICIs in combination with targeted therapies.