Further, the systemic therapies used for ccRCC, including vascular endothelial growth factor tyrosine kinase inhibitors, mTOR inhibitors, and immune checkpoint inhibitor therapies, are completely ineffective against RMC.14,15,20,21 Conversely, the cytotoxic and epidermal growth factor receptor targeted therapies used in RMC have no activity against ccRCC.14,15,22,23. This evidence concerns the gene MTOR and nonpapillary renal cell carcinoma.