A key to developing novel treatment approaches for rare cancers is unraveling elements of their biology. In this issue of ESMO Open, Rametta et al.1 do just that, highlighting the expression of two antigens (nectin-4 and trop-2) in patients with collecting duct carcinoma (Figure 1). It is important to recognize that collecting duct carcinoma represents a diagnosis of exclusion, with the differential diagnosis including other renal medulla-derived cancer types such as upper tract urothelial carcinoma and renal medullary carcinoma.
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Agarwal et al. (2026) studied this question.
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