This study is the first to propose that future research into the miR-148/ADAMTS18 genes and the ferroptosis pathway in tRCC and pRCC could lead to the development of new therapies and the identification of novel therapeutic targets, potentially overcoming drug resistance and metastasis. Here, ADAMTS18 is linked to renal cell carcinoma associated with Xp11.2 translocations/TFE3 gene fusions.