These results suggest that ccRCC patients with VHL gene mutations (>50% of patients) [57] that do not express HIF1α (~70% of ccRCC patients [58]) could have an improved response to sunitinib treatment through targeting of PD-L1 by checkpoint inhibitor antibodies such as avelumab that already has FDA-approval for combination treatment in ccRCC [59]. Here, VHL is linked to nonpapillary renal cell carcinoma.