Renal cell carcinoma (RCC) is one of the most common tumours of the urinary system, and is insidious and not susceptible to chemoradiotherapy. As the most common subtype of RCC (70–80% of cases), clear cell renal cell carcinoma (ccRCC) is characterized by the loss of von Hippel–Lindau and the accumulation of robust lipid and glycogen. For advanced RCC, molecular‐targeted drugs, tyrosine kinase inhibitors (TKIs) and the immune checkpoint inhibitors (ICIs) have been increasingly recommended and investigated. Due to the existence of a highly dynamic, adaptive and heterogeneous tumour microenvironment (TME), and due to the glucose and lipid metabolism in RCC, this cancer may be accompanied by various types of resistance to TKIs and ICIs. With the increased production of lactate, nitric oxide, and other new by‐products of metabolism, novel findings of the TME and key metabolic enzymes drived by HIF and other factors have been increasingly clarified in RCC carcinogenesis and therapy. However, there are few summaries of the TME and tumour metabolism for RCC progression and therapy. Here, we summarize and discuss the relationship of the important implicated characteristics of the TME as well as metabolic molecules and RCC carcinogenesis to provide prospects for future treatment strategies to overcome TME‐related resistance in RCC.

中文翻译：

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肾细胞癌靶向或免疫治疗中的肿瘤微环境和代谢。

肾细胞癌 (RCC) 是泌尿系统最常见的肿瘤之一，并且隐匿且不易受到放化疗的影响。作为 RCC 最常见的亚型（占病例的 70-80%），透明细胞肾细胞癌 (ccRCC) 的特征是 von Hippel-Lindau 的丧失以及强大的脂质和糖原的积累。对于晚期 RCC，越来越多地推荐和研究分子靶向药物、酪氨酸激酶抑制剂 (TKIs) 和免疫检查点抑制剂 (ICIs)。由于存在高度动态、适应性和异质性的肿瘤微环境（TME），并且由于 RCC 中的糖和脂质代谢，这种癌症可能伴随着对 TKI 和 ICI 的各种类型的耐药性。随着乳酸、一氧化氮和其他新的代谢副产物的产生，由 HIF 和其他因素驱动的 TME 和关键代谢酶的新发现在 RCC 的致癌作用和治疗中越来越得到阐明。然而，关于 RCC 进展和治疗的 TME 和肿瘤代谢的总结很少。在这里，我们总结并讨论了 TME 的重要牵连特征以及代谢分子与 RCC 癌变之间的关系，为未来克服 RCC 中 TME 相关耐药性的治疗策略提供了前景。