Sarcomatoid Renal Cell Carcinoma: Biological Features and Therapeutic Implications—A Narrative Review

This review underscores the importance of recognizing sarcomatoid features in renal cell carcinoma, as this component significantly impacts prognosis and treatment strategies. Sarcomatoid renal cell carcinoma (sRCC) is a rare and aggressive form of renal cancer characterized by poor prognosis and distinct biological features. Despite its clinical significance, there remains a knowledge gap regarding the comprehensive understanding of its molecular and therapeutic landscape. Recent studies provided an extensive overview of the clinical, pathological, and molecular characteristics of sRCC, highlighting its unique genomic alterations and immune profile. Notably, sRCC exhibits a highly inflamed tumor microenvironment, which correlates with increased responsiveness to immune checkpoint inhibitors. Our findings suggest that integrating immunotherapy into the management of sRCC could enhance patient outcomes, paving the way for future research and clinical applications in this challenging cancer subtype.