Development and Validation of an Intratumor Heterogeneity–Based Prognostic Model for Clear Cell Renal Cell Carcinoma

We developed and validated the ITHscore, a three-gene expression-based model with superior prognostic performance in ccRCC. The ITHscore reflects key features of aggressiveness in tumor biology, including immune evasion and ICB resistance. Its minimal gene set and consistent performance across data sets support its potential for clinical implementation in ccRCC stratification.