Objective  To systematically analyze the research hotspots and development trends of drug resistance mechanisms in renal cell carcinoma (RCC), and to provide a reference for research in this field.

Methods  The literature related to drug resistance in treatment of RCC was obtained from Web of Science core collection. CiteSpace software was used for keyword clustering and trend analysis, and VOSviewer software was used for keyword co-occurrence network analysis.

Results  In total, 1 392 literature were incorporated, including 736 regarding targeted therapy, 158 in immunotherapy, and 369 in chemotherapy. The overall research trend in this field was on the rise, in which the research on targeted therapy resistance occupies a dominant position, and immunotherapy resistance was a new research direction. Key words in this field were focused on molecular mechanisms of drug resistance, potential signaling pathways, combination therapy, indicators, and novel therapy. The evolution of keywords and theme words suggests that the research tendency of RCC targeted therapy resistance in recent years focuses on the exploration of new mechanisms of drug resistance and the application of multi-target drugs. The research trend of immunotherapy resistance highlights combination therapy, tumor microenvironment, and metastasis correlation. The research trend of chemotherapy resistance focused on pharmacokinetic-related factors, multidrug resistance genes.

Conclusion  To provide references for researchers to accurately grasp the research status and development trend of drug resistance in RCC.

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