A 22-gene signature (BONSAI) clusters patients into a first group (n=6) with increased expression of 19/22 genes (BONSAIhigh) and longer PFS and OS....BONSAI high patients exhibit best response rate to cabozantinib, while no clear association with metastasis localization, tumor mutational burden and LOH state is observed….mCDC is featured by a prognostic signature associating T cell immunity and angiogenesis with good clinical outcome and sensitivity to cabozantinib, differently from ccRCC.