UROONKOLOJI BULTENI-BULLETIN OF UROONCOLOGY, cilt.18, sa.2, ss.73-79, 2019 (ESCI)
Renal cell carcinoma (RCC) exhibits multidrug resistance protein P-glycoprotein expression due to the proximal tubular origin and in this regard, it is resistant to a large number of cytotoxic chemotherapy. The identification of the molecular pathogenesis, genetics, and epigenetics of RCC has led to new target points such as vascular endothelial growth factor. Tyrosine kinase inhibitors have been used mainly for treatment, but recently, immune checkpoint inhibitors have also been used in the treatment of RCC. Despite these treatments, response rates are not sufficient in the majority of patients. Primary resistance or acquired resistance to the treatment might be seen. Defining these resistance mechanisms will contribute to the management of the treatment and will help in to identify new treatment targets. In this review, we focus on the molecular mechanisms and resistance mechanisms of targeted-therapy.