In this framework, RCC immunobiology supports perioperative strategies that (1) prime and diversify tumor-reactive T cells with neoadjuvant therapy, (2) maintain immune pressure in the adjuvant setting, and (3) adapt treatment intensity using translational readouts (e.g., CD39+/TCF-1+ CD8, KIM-1, ctDNA). Here, ENTPD1 is linked to neoplasm.