On the other hand, Bossé et al. reported on the prognostic value of genetic alterations resulting in loss of function (defined by the presence of pathogenic gene variant or 2 copy deletion) of VHL, PBRM1, BAP1, SETD2, TP53, and KDM5C, which are frequently mutated in metastatic RCC, in patients with ccRCC stratified by IMDC risk classification and treated with 1st line VEGFR tyrosine kinase inhibitors (38). This evidence concerns the gene VHL and nonpapillary renal cell carcinoma.