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Ball MW, An JY, Gomella PT, Gautam R, Ricketts CJ, Vocke CD, Schmidt LS, Merino MJ, Srinivasan R, Malayeri AA, Metwalli AR, Linehan WM. Growth Rates of Genetically Defined Renal Tumors: Implications for Active Surveillance and Intervention. J Clin Oncol 2020; 38:1146-1153. [PMID: 32083993 PMCID: PMC7145590 DOI: 10.1200/jco.19.02263] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2020] [Indexed: 01/10/2023] Open
Abstract
PURPOSE Published series of growth rates of renal tumors on active surveillance largely consist of tumors without pathologic or genetic data. Growth kinetics of genetically defined renal tumors are not well known. Here, we evaluate the growth of genetically defined renal tumors and their association with patient clinical and genetic characteristics. PATIENTS AND METHODS We evaluated patients with an inherited kidney cancer susceptibility syndrome as a result of a pathologic germline alteration of VHL, MET, FLCN, or BAP1 with at least 1 solid renal mass managed with active surveillance at our institution. Tumor growth rates (GR) were calculated and patients were stratified by genetic alteration and other clinical and genetic factors to analyze differences in growth rates using linear regression and comparative statistics. RESULTS A total of 292 patients with 435 genetically defined tumors were identified, including 286 VHL-deficient, 91 FLCN-deficient, 52 MET-activated, and 6 BAP1-deficient tumors. There were significant differences in GRs when stratified by genetic alteration. BAP1-deficient tumors had the fastest median GR (0.6 cm/y; interquartile range [IQR], 0.57-0.68 cm/y), followed by VHL-deficient tumors (GR, 0.37 cm/y; IQR, 0.25-0.57 cm/y), FLCN-deficient tumors (GR, 0.10 cm/y; IQR, 0.04-0.24 cm/y), and tumors with MET activation (GR, 0.15 cm/y; IQR, 0.053-0.32 cm/y; P < .001). Tumors from the same patient had similar GRs. Younger age was independently associated with higher GR (P = .005). CONCLUSION In a cohort of genetically defined tumors, tumor growth rates varied in a clinically and statistically different manner according to genetic subtype. Rapid growth of BAP1-deficient tumors indicates that these patients should be managed with caution. The faster growth of tumors in younger patients may support more frequent imaging, whereas the slower growth of other tumors may support extended surveillance beyond annual imaging in some instances.
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Affiliation(s)
- Mark W. Ball
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Julie Y. An
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Patrick T. Gomella
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Rabindra Gautam
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Christopher J. Ricketts
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Cathy D. Vocke
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Laura S. Schmidt
- Basic Science Program, Frederick National Laboratory for Cancer Research, Frederick, MD
| | - Maria J. Merino
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Ramaprasad Srinivasan
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Ashkan A. Malayeri
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Adam R. Metwalli
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - W. Marston Linehan
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
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Abstract
PURPOSE OF REVIEW To describe current paradigms for genetic testing, screening, and treatment of patients with inherited kidney cancer syndromes. RECENT FINDINGS We describe various new aspects of hereditary kidney cancer. Recent data now support that hereditary kidney cancer may account for 5-8% of kidney cancers diagnosed. Methods of testing have evolved including the introduction of multigene next-generation sequencing panels. We continue to learn more about the natural history and management of classic hereditary cancer syndromes. New emerging conditions with lower kidney cancer penetrance have been recognized adding the growing list of syndromes associated with kidney cancer development. The surgical management strategies of enucleation remain however systemic therapy options are being explored both for localized and advanced settings. SUMMARY Genetic predisposition to kidney cancer is likely more common than once thought. Knowledge of clinical manifestation and genetic testing strategies are needed to properly identify and treat patient and their families.
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Podkalicka P, Mucha O, Kruczek S, Biela A, Andrysiak K, Stępniewski J, Mikulski M, Gałęzowski M, Sitarz K, Brzózka K, Józkowicz A, Dulak J, Łoboda A. Synthetically Lethal Interactions of Heme Oxygenase-1 and Fumarate Hydratase Genes. Biomolecules 2020; 10:biom10010143. [PMID: 31963199 PMCID: PMC7023083 DOI: 10.3390/biom10010143] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 01/10/2020] [Accepted: 01/14/2020] [Indexed: 12/26/2022] Open
Abstract
Elevated expression of heme oxygenase-1 (HO-1, encoded by HMOX1) is observed in various types of tumors. Hence, it is suggested that HO-1 may serve as a potential target in anticancer therapies. A novel approach to inhibit HO-1 is related to the synthetic lethality of this enzyme and fumarate hydratase (FH). In the current study, we aimed to validate the effect of genetic and pharmacological inhibition of HO-1 in cells isolated from patients suffering from hereditary leiomyomatosis and renal cell carcinoma (HLRCC)-an inherited cancer syndrome, caused by FH deficiency. Initially, we confirmed that UOK 262, UOK 268, and NCCFH1 cell lines are characterized by non-active FH enzyme, high expression of Nrf2 transcription factor-regulated genes, including HMOX1 and attenuated oxidative phosphorylation. Later, we demonstrated that shRNA-mediated genetic inhibition of HMOX1 resulted in diminished viability and proliferation of cancer cells. Chemical inhibition of HO activity using commercially available inhibitors, zinc and tin metalloporphyrins as well as recently described new imidazole-based compounds, especially SLV-11199, led to decreased cancer cell viability and clonogenic potential. In conclusion, the current study points out the possible relevance of HO-1 inhibition as a potential anti-cancer treatment in HLRCC. However, further studies revealing the molecular mechanisms are still needed.
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Affiliation(s)
- Paulina Podkalicka
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387 Kraków, Poland; (P.P.); (O.M.); (S.K.); (A.B.); (K.A.); (J.S.); (A.J.); (J.D.)
| | - Olga Mucha
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387 Kraków, Poland; (P.P.); (O.M.); (S.K.); (A.B.); (K.A.); (J.S.); (A.J.); (J.D.)
| | - Szczepan Kruczek
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387 Kraków, Poland; (P.P.); (O.M.); (S.K.); (A.B.); (K.A.); (J.S.); (A.J.); (J.D.)
| | - Anna Biela
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387 Kraków, Poland; (P.P.); (O.M.); (S.K.); (A.B.); (K.A.); (J.S.); (A.J.); (J.D.)
| | - Kalina Andrysiak
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387 Kraków, Poland; (P.P.); (O.M.); (S.K.); (A.B.); (K.A.); (J.S.); (A.J.); (J.D.)
| | - Jacek Stępniewski
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387 Kraków, Poland; (P.P.); (O.M.); (S.K.); (A.B.); (K.A.); (J.S.); (A.J.); (J.D.)
| | - Maciej Mikulski
- Ryvu Therapeutics S.A., Bobrzyńskiego 14, 30-348 Kraków, Poland; (M.M.); (M.G.); (K.S.); (K.B.)
| | - Michał Gałęzowski
- Ryvu Therapeutics S.A., Bobrzyńskiego 14, 30-348 Kraków, Poland; (M.M.); (M.G.); (K.S.); (K.B.)
| | - Kamil Sitarz
- Ryvu Therapeutics S.A., Bobrzyńskiego 14, 30-348 Kraków, Poland; (M.M.); (M.G.); (K.S.); (K.B.)
| | - Krzysztof Brzózka
- Ryvu Therapeutics S.A., Bobrzyńskiego 14, 30-348 Kraków, Poland; (M.M.); (M.G.); (K.S.); (K.B.)
| | - Alicja Józkowicz
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387 Kraków, Poland; (P.P.); (O.M.); (S.K.); (A.B.); (K.A.); (J.S.); (A.J.); (J.D.)
| | - Józef Dulak
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387 Kraków, Poland; (P.P.); (O.M.); (S.K.); (A.B.); (K.A.); (J.S.); (A.J.); (J.D.)
| | - Agnieszka Łoboda
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387 Kraków, Poland; (P.P.); (O.M.); (S.K.); (A.B.); (K.A.); (J.S.); (A.J.); (J.D.)
- Correspondence:
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Sourbier C, Ricketts CJ, Liao PJ, Matsumoto S, Wei D, Lang M, Railkar R, Yang Y, Wei MH, Agarwal P, Krishna M, Mitchell JB, Trepel JB, Neckers L, Linehan WM. Proteasome inhibition disrupts the metabolism of fumarate hydratase- deficient tumors by downregulating p62 and c-Myc. Sci Rep 2019; 9:18409. [PMID: 31804603 PMCID: PMC6895110 DOI: 10.1038/s41598-019-55003-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 11/21/2019] [Indexed: 11/18/2022] Open
Abstract
Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is characterized by germline mutations of the FH gene that encodes for the TCA cycle enzyme, fumarate hydratase. HLRCC patients are at risk for the development of an aggressive form of type 2 papillary renal cell carcinoma. By studying the mechanism of action of marizomib, a proteasome inhibitor able to cross the blood-brain barrier, we found that it modulates the metabolism of HLRCC cells. Marizomib decreased glycolysis in vitro and in vivo by downregulating p62 and c-Myc. C-Myc downregulation decreased the expression of lactate dehydrogenase A, the enzyme catalyzing the conversion of pyruvate to lactate. In addition, proteasomal inhibition lowered the expression of the glutaminases GLS and GLS2, which support glutamine metabolism and the maintenance of the redox balance. Thus, in HLRCC cells, proteasome inhibition disrupts glucose and glutamine metabolism, restricting nutrients and lowering the cells’ anti-oxidant response capacity. Although the cytotoxicity induced by proteasome inhibitors is complex, the understanding of their metabolic effects in HLRCC may lead to the development of effective therapeutic strategies or to the development of markers of efficacy.
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Affiliation(s)
- Carole Sourbier
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America. .,Office of Biotechnology Products, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, US Food & Drug Administration, Silver Spring, Maryland, United States of America.
| | - Christopher J Ricketts
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Pei-Jyun Liao
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America.,Office of Biotechnology Products, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, US Food & Drug Administration, Silver Spring, Maryland, United States of America
| | - Shingo Matsumoto
- Radiation Biology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America.,Division of Bioengineering and Bioinformatics, Graduate School of Information Science and Technology, Hokkaido University, Sapporo, Japan.,JST, PREST, Saitama, Japan
| | - Darmood Wei
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Martin Lang
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Reema Railkar
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Youfeng Yang
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Ming-Hui Wei
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Piyush Agarwal
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Murali Krishna
- Radiation Biology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America
| | - James B Mitchell
- Radiation Biology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Jane B Trepel
- Developmental Therapeutics Branch, Center for Cancer Research, NCI, Bethesda, Maryland, United States of America
| | - Len Neckers
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America
| | - W Marston Linehan
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America.
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Carlo MI, Hakimi AA, Stewart GD, Bratslavsky G, Brugarolas J, Chen YB, Linehan WM, Maher ER, Merino MJ, Offit K, Reuter VE, Shuch B, Coleman JA. Familial Kidney Cancer: Implications of New Syndromes and Molecular Insights. Eur Urol 2019; 76:754-764. [PMID: 31326218 PMCID: PMC7673107 DOI: 10.1016/j.eururo.2019.06.015] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 06/12/2019] [Indexed: 02/07/2023]
Abstract
CONTEXT Hereditary cases account for about 5% of all cases of renal cell carcinoma (RCC). With advances in next-generation sequencing, several new hereditary syndromes have been described in the last few years. OBJECTIVE To review and summarise the recent preclinical and clinical literature in hereditary renal cancer. EVIDENCE ACQUISITION A systematic review of the literature was performed in November 2018 using PubMed and OMIM databases, with an emphasis on kidney cancer, genetics and genomics, clinical criteria, and management. EVIDENCE SYNTHESIS Several autosomal dominant hereditary RCC syndromes have been described, including those related to germline pathogenic variants in VHL, MET, FH, TSC1/TSC2, FLCN, SDHA/B/C/D, BAP1, CDC73, and MITF. Clinical spectrum of SDH, BAP1, and MITF is still being defined, although these appear to be associated with a lower incidence of RCC. FH and likely BAP1 RCC are associated with more aggressive disease. Preclinical and clinical studies show that using systemic therapy that exploits specific genetic pathways is a promising strategy. CONCLUSIONS There are several well-described hereditary RCC syndromes, as well as recently identified ones, for which the full clinical spectrum is yet to be defined. In the new era of precision medicine, identification of these syndromes may play an important role in management and systemic treatment selection. PATIENT SUMMARY This review covers updates in the diagnosis and management of familial kidney cancer syndromes. We describe updates in testing and management of the most common syndromes such as von Hippel-Lindau, and hereditary leiomyomatosis and renal cell carcinoma. We also provide insights into recently described familial kidney cancer syndromes.
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Affiliation(s)
- Maria I Carlo
- Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - A Ari Hakimi
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Grant D Stewart
- Department of Surgery, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | | | | | - Ying-Bei Chen
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - W Marston Linehan
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Eamonn R Maher
- Department of Surgery, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK; Department of Medical Genetics, University of Cambridge and NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Cenre, Cambridge, UK
| | - Maria J Merino
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kenneth Offit
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Brian Shuch
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Choi Y, Keam B, Kim M, Yoon S, Kim D, Choi JG, Seo JY, Park I, Lee JL. Bevacizumab Plus Erlotinib Combination Therapy for Advanced Hereditary Leiomyomatosis and Renal Cell Carcinoma-Associated Renal Cell Carcinoma: A Multicenter Retrospective Analysis in Korean Patients. Cancer Res Treat 2019; 51:1549-1556. [PMID: 30913859 PMCID: PMC6790829 DOI: 10.4143/crt.2019.086] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 03/23/2019] [Indexed: 01/30/2023] Open
Abstract
PURPOSE Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is a rare genetic syndrome resulting from germline mutations in fumarate hydratase. The combination of bevacizumab plus erlotinib showed promising interim results for HLRCC-associated RCC. Based on these results, we analyzed the outcome of bevacizumab plus erlotinib in Korean patients with HLRCC-associated RCC. MATERIALS AND METHODS We retrospectively reviewed the efficacy and safety of bevacizumab plus erlotinib in patients with HLRCC-associated RCC who were confirmed to have germline mutations in fumarate hydratase. The primary endpoint was the objective response rate (ORR), while the secondary endpoints were progression-free survival (PFS) and overall survival (OS). RESULT We identified 10 patients with advanced HLRCC-associated RCC who received bevacizumab plus erlotinib. Median age at diagnosis was 41 years, and five of the patients had received the combination as first- or second-line treatments. The ORR was 50% and the median PFS and OS were 13.3 and 14.1 months, respectively. Most adverse events were predictable and manageable by conventional measures, except for one instance where a patient died of gastrointestinal bleeding. CONCLUSION This is the first real-world outcome of the treatment of advanced HLRCC-associated RCC. Bevacizumab plus erlotinib therapy showed promising activity with moderate toxicity. We should be increasingly aware of HLRCC-associated RCC and bevacizumab plus erlotinib should be a first-line treatment for this condition, unless other promising data are published.
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Affiliation(s)
- Yeonjoo Choi
- Division of Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Bhumsuk Keam
- Division of Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Miso Kim
- Division of Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Shinkyo Yoon
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dalyong Kim
- Division of Hematology and Medical Oncology, Dongguk University Ilsan Hospital, Ilsan, Korea
| | - Jong Gwon Choi
- Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Ja Young Seo
- Department of Laboratory Medicine, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Inkeun Park
- Division of Medical Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Jae Lyun Lee
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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A Clinicopathologic and Molecular Analysis of Fumarate Hydratase-deficient Renal Cell Carcinoma in 32 Patients. Am J Surg Pathol 2019; 44:98-110. [DOI: 10.1097/pas.0000000000001372] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Skala SL, Dhanasekaran SM, Mehra R. Hereditary Leiomyomatosis and Renal Cell Carcinoma Syndrome (HLRCC): A Contemporary Review and Practical Discussion of the Differential Diagnosis for HLRCC-Associated Renal Cell Carcinoma. Arch Pathol Lab Med 2019; 142:1202-1215. [PMID: 30281371 DOI: 10.5858/arpa.2018-0216-ra] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Hereditary leiomyomatosis and renal cell carcinoma syndrome (HLRCC) is an uncommon disorder with germline-inactivating mutations in the fumarate hydratase ( FH) gene. The kidney cancers that develop in patients with HLRCC are often unilateral and solitary, with a potentially aggressive clinical course; morphologic identification of suspicious cases is of the utmost importance. OBJECTIVE.— To review classic morphologic features of HLRCC-associated renal cell carcinoma, the reported morphologic spectrum of these tumors and their mimics, and the evidence for use of immunohistochemistry and molecular testing in diagnosis of these tumors. DATA SOURCES.— University of Michigan cases and review of pertinent literature about HLRCC and the morphologic spectrum of HLRCC-associated renal cell carcinoma. CONCLUSIONS.— Histologic features, such as prominent nucleoli with perinucleolar halos and multiple architectural patterns within one tumor, are suggestive of HLRCC-associated renal cell carcinoma. However, the morphologic spectrum is broad. Appropriate use of FH immunohistochemistry and referral to genetic counseling is important for detection of this syndrome.
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Affiliation(s)
| | | | - Rohit Mehra
- From the Department of Pathology, University of Michigan Medical School, Ann Arbor (Drs Skala and Mehra); the Rogel Cancer Center, Michigan Medicine, Ann Arbor (Dr Mehra); and the Department of Pathology, Michigan Center for Translational Pathology, University of Michigan Health System, Ann Arbor (Drs Dhanasekaran and Mehra)
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Diaz de Leon A, Pirasteh A, Costa DN, Kapur P, Hammers H, Brugarolas J, Pedrosa I. Current Challenges in Diagnosis and Assessment of the Response of Locally Advanced and Metastatic Renal Cell Carcinoma. Radiographics 2019; 39:998-1016. [PMID: 31199711 DOI: 10.1148/rg.2019180178] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Locally advanced and metastatic renal cell carcinoma (RCC) present a specific set of challenges to the radiologist. The detection of metastatic disease is confounded by the ability of RCC to metastasize to virtually any part of the human body long after surgical resection of the primary tumor. This includes sites not commonly included in routine surveillance, which come to light after the patient becomes symptomatic. In the assessment of treatment response, the phenomenon of tumor heterogeneity, where clone selection through systemic therapy drives the growth of potentially more aggressive phenotypes, can result in oligoprogression despite overall disease control. Finally, advances in therapy have resulted in the development of immuno-oncologic agents that may result in changes that are not adequately evaluated with conventional size-based response criteria and may even be misinterpreted as progression. This article reviews the common challenges a radiologist may encounter in the evaluation of patients with locally advanced and metastatic RCC. ©RSNA, 2019.
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Affiliation(s)
- Alberto Diaz de Leon
- From the Department of Radiology (A.D.d.L., A.P., D.N.C., I.P.), Advanced Imaging Research Center (D.N.C., I.P.), Department of Pathology (P.K.), Department of Urology (P.K.), Kidney Cancer Program-Simmons Comprehensive Cancer Center (P.K., H.H., J.B., I.P.), and Department of Internal Medicine (H.H., J.B.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Ali Pirasteh
- From the Department of Radiology (A.D.d.L., A.P., D.N.C., I.P.), Advanced Imaging Research Center (D.N.C., I.P.), Department of Pathology (P.K.), Department of Urology (P.K.), Kidney Cancer Program-Simmons Comprehensive Cancer Center (P.K., H.H., J.B., I.P.), and Department of Internal Medicine (H.H., J.B.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Daniel N Costa
- From the Department of Radiology (A.D.d.L., A.P., D.N.C., I.P.), Advanced Imaging Research Center (D.N.C., I.P.), Department of Pathology (P.K.), Department of Urology (P.K.), Kidney Cancer Program-Simmons Comprehensive Cancer Center (P.K., H.H., J.B., I.P.), and Department of Internal Medicine (H.H., J.B.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Payal Kapur
- From the Department of Radiology (A.D.d.L., A.P., D.N.C., I.P.), Advanced Imaging Research Center (D.N.C., I.P.), Department of Pathology (P.K.), Department of Urology (P.K.), Kidney Cancer Program-Simmons Comprehensive Cancer Center (P.K., H.H., J.B., I.P.), and Department of Internal Medicine (H.H., J.B.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Hans Hammers
- From the Department of Radiology (A.D.d.L., A.P., D.N.C., I.P.), Advanced Imaging Research Center (D.N.C., I.P.), Department of Pathology (P.K.), Department of Urology (P.K.), Kidney Cancer Program-Simmons Comprehensive Cancer Center (P.K., H.H., J.B., I.P.), and Department of Internal Medicine (H.H., J.B.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - James Brugarolas
- From the Department of Radiology (A.D.d.L., A.P., D.N.C., I.P.), Advanced Imaging Research Center (D.N.C., I.P.), Department of Pathology (P.K.), Department of Urology (P.K.), Kidney Cancer Program-Simmons Comprehensive Cancer Center (P.K., H.H., J.B., I.P.), and Department of Internal Medicine (H.H., J.B.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Ivan Pedrosa
- From the Department of Radiology (A.D.d.L., A.P., D.N.C., I.P.), Advanced Imaging Research Center (D.N.C., I.P.), Department of Pathology (P.K.), Department of Urology (P.K.), Kidney Cancer Program-Simmons Comprehensive Cancer Center (P.K., H.H., J.B., I.P.), and Department of Internal Medicine (H.H., J.B.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
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Linehan WM, Schmidt LS, Crooks DR, Wei D, Srinivasan R, Lang M, Ricketts CJ. The Metabolic Basis of Kidney Cancer. Cancer Discov 2019; 9:1006-1021. [PMID: 31088840 DOI: 10.1158/2159-8290.cd-18-1354] [Citation(s) in RCA: 145] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/19/2019] [Accepted: 03/22/2019] [Indexed: 01/27/2023]
Abstract
Kidney cancer is not a single disease but represents several distinct types of cancer that have defining histologies and genetic alterations and that follow different clinical courses and have different responses to therapy. Mutation of genes associated with kidney cancer, such as VHL, FLCN, TFE3, FH, or SDHB, dysregulates the tumor's responses to changes in oxygen, iron, nutrient, or energy levels. The identification of these varying genetic bases of kidney cancer has increased our understanding of the biology of this cancer, allowing the development of targeted therapies and the appreciation that it is a cancer driven by metabolic alterations. SIGNIFICANCE: Kidney cancer is a complex disease composed of different types of cancer that present with different histologies, clinical courses, genetic changes, and responses to therapy. This review describes the known genetic changes within kidney cancer, how they alter tumor metabolism, and how these metabolic changes can be therapeutically targeted.
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Affiliation(s)
- W Marston Linehan
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
| | - Laura S Schmidt
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.,Basic Science Program, Frederick Laboratory for Cancer Research, Frederick, Maryland
| | - Daniel R Crooks
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Darmood Wei
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Ramaprasad Srinivasan
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Martin Lang
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Christopher J Ricketts
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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Pivovarcikova K, Martinek P, Grossmann P, Trpkov K, Alaghehbandan R, Magi-Galluzzi C, Pane Foix M, Condom Mundo E, Berney D, Gill A, Rychly B, Michalova K, Rogala J, Pitra T, Micsik T, Polivka J, Hora M, Tanas Isikci O, Skalova S, Mareckova J, Michal M, Hes O. Fumarate hydratase deficient renal cell carcinoma: Chromosomal numerical aberration analysis of 12 cases. Ann Diagn Pathol 2019; 39:63-68. [DOI: 10.1016/j.anndiagpath.2019.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 02/08/2019] [Indexed: 12/30/2022]
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62
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Trpkov K, Hes O. New and emerging renal entities: a perspective post-WHO 2016 classification. Histopathology 2018; 74:31-59. [DOI: 10.1111/his.13727] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/08/2018] [Accepted: 08/09/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Kiril Trpkov
- University of Calgary and Calgary Laboratory Services; Calgary Alberta Canada
| | - Ondřej Hes
- Charles University and University Hospital Pilsen; Pilsen Czech Republic
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63
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Warren AY, Harrison D. WHO/ISUP classification, grading and pathological staging of renal cell carcinoma: standards and controversies. World J Urol 2018; 36:1913-1926. [PMID: 30123932 PMCID: PMC6280811 DOI: 10.1007/s00345-018-2447-8] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 08/12/2018] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Pathological parameters assessed on biopsies and resection specimens have a pivotal role in the diagnosis, prognosis and management of patients with renal cell carcinoma (RCC). METHODS A non-systematic literature search was performed, updated to January 2018, to identify key standards and controversies in the pathological classification, grading and staging of RCC. RESULTS Although most RCCs exhibit characteristic morphology that enables easy categorisation, RCCs show considerable morphological heterogeneity and it is not uncommon for there to be difficulty in assigning a tumour type, especially with rarer tumour subtypes. The differentiation between benign and malignant oncocytic tumours remains a particular challenge. The development of additional immunohistochemical and molecular tests is needed to facilitate tumour typing, because of the prognostic and therapeutic implications, and to enable more reliable identification of poorly differentiated metastatic tumours as being of renal origin. Any new tests need to be applicable to small biopsy samples, to overcome the heterogeneity of renal tumours. There is also a need to facilitate identification of tumour types that have genetic implications, to allow referral and management at specialist centres. Digital pathology has a potential role in such referral practice. CONCLUSION Much has been done to standardise pathological assessment of renal cell carcinomas in recent years, but there still remain areas of difficulty in classification and grading of these heterogeneous tumours.
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Affiliation(s)
- Anne Y Warren
- Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK.
| | - David Harrison
- School of Medicine, University of St Andrews, St Andrews, KY16 9TF, UK
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64
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Bensalah K, Albiges L, Bernhard JC, Bigot P, Bodin T, Boissier R, Correas JM, Gimel P, Hetet JF, Long JA, Nouhaud FX, Ouzaïd I, Rioux-Leclercq N, Méjean A. Recommandations françaises du Comité de Cancérologie de l’AFU – Actualisation 2018–2020 : prise en charge du cancer du rein. Prog Urol 2018; 28 Suppl 1:R5-R33. [DOI: 10.1016/j.purol.2019.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 09/15/2018] [Indexed: 12/15/2022]
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65
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Shuch B, Zhang J. Genetic Predisposition to Renal Cell Carcinoma: Implications for Counseling, Testing, Screening, and Management. J Clin Oncol 2018; 36:JCO2018792523. [PMID: 30372385 DOI: 10.1200/jco.2018.79.2523] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In many individuals with renal cell carcinoma (RCC), a hereditary cause may have contributed to cancer development. Various risk factors can be suggestive of a genetic contribution, including early disease onset, multifocal or bilateral tumors, family history of RCC, and personal/family history of other benign or malignant tumors. Genetic counseling and understanding of the entire family tree are the first steps in evaluation and will determine if the patient should proceed with testing. Methods of testing have changed to next-generation sequencing, which allows multiple genes to be evaluated together. The results of testing have significant implications for the individual and his or her family members. Screening of the kidney and at-risk organs ensues, with most algorithms focused on early diagnosis and intervention to limit morbidity and mortality of disease manifestations. A comprehensive clinical program that can offer multidisciplinary care is useful for several complex cancer syndromes. Management of localized and advanced hereditary kidney cancers may differ from the sporadic forms of RCC. Knowledge of the genetics can have significant management implications and if necessary genetic evaluation can be expedited to allow treatment decisions.
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Affiliation(s)
- Brian Shuch
- Brian Shuch, Yale School of Medicine and Yale Cancer Center, New Haven, CT; and Jin Zhang, RenJi Hospital and Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jin Zhang
- Brian Shuch, Yale School of Medicine and Yale Cancer Center, New Haven, CT; and Jin Zhang, RenJi Hospital and Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
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66
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Bensalah K, Albiges L, Bernhard JC, Bigot P, Bodin T, Boissier R, Correas JM, Gimel P, Hetet JF, Long JA, Nouhaud FX, Ouzaïd I, Rioux-Leclercq N, Méjean A. RETRACTED: Recommandations françaises du Comité de Cancérologie de l’AFU – Actualisation 2018–2020 : prise en charge du cancer du reinFrench ccAFU guidelines – Update 2018–2020: Management of kidney cancer. Prog Urol 2018; 28:S3-S31. [PMID: 30473002 DOI: 10.1016/j.purol.2018.09.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 09/15/2018] [Indexed: 12/15/2022]
Abstract
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy).
Cet article est retiré de la publication à la demande des auteurs car ils ont apporté des modifications significatives sur des points scientifiques après la publication de la première version des recommandations.
Le nouvel article est disponible à cette adresse: DOI:10.1016/j.purol.2019.01.004.
C’est cette nouvelle version qui doit être utilisée pour citer l’article.
This article has been retracted at the request of the authors, as it is not based on the definitive version of the text because some scientific data has been corrected since the first issue was published.
The replacement has been published at the DOI:10.1016/j.purol.2019.01.004.
That newer version of the text should be used when citing the article.
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Affiliation(s)
- K Bensalah
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service d'urologie, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35033, Rennes cedex, France.
| | - L Albiges
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Département d'oncologie génito-urinaire, Gustave-Roussy, 94805, Villejuif cedex, France
| | - J-C Bernhard
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service d'urologie et transplantation rénale, CHU de Bordeaux, place Amélie-Raba-Léon, 33076, Bordeaux, France
| | - P Bigot
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service d'urologie, CHU d'Angers, 4, rue Larrey, 49000, Angers, France
| | - T Bodin
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Centre d'urologie Prado-Louvain, 188, rue du Rouet, 13008, Marseille, France
| | - R Boissier
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service d'urologie et transplantation rénale, CHU Conception, 147, boulevard Baille, 13005, Marseille, France
| | - J-M Correas
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service d'imagerie médicale (radiologie), hôpital universitaire Necker-Enfants-malades, 149, rue de Sèvres, 75015, Paris, France
| | - P Gimel
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Centre d'urologie, site Médipôle, 5, avenue Ambroise-Croizat, 66330, Cabestany, France
| | - J-F Hetet
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service de chirurgie urologique, clinique Jules-Verne, 2-4, route de Paris, 44314, Nantes, France
| | - J-A Long
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service de chirurgie urologique et de la transplantation rénale, hôpital Michallon, CHU Grenoble, boulevard de la Chantourne, 38700, La Tronche, France
| | - F-X Nouhaud
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service d'urologie, CHU de Rouen, 1, rue de Germont, 76000, Rouen, France
| | - I Ouzaïd
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Clinique urologique, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018, Paris, France
| | - N Rioux-Leclercq
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service d'anatomie et cytologie pathologiques, CHU Pontchaillou, 2, rue Henri-le-Guilloux, 35033, Rennes cedex 9, France
| | - A Méjean
- Comité de cancérologie de l'Association française d'urologie, groupe rein, maison de l'urologie, 11, rue Viète, 75017, Paris, France; Service d'urologie, hôpital européen Georges-Pompidou, université Paris Descartes, AP-HP, 75015, Paris, France
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Xu Y, Taylor P, Andrade J, Ueberheide B, Shuch B, Glazer PM, Bindra RS, Moran MF, Linehan WM, Neel BG. Pathologic Oxidation of PTPN12 Underlies ABL1 Phosphorylation in Hereditary Leiomyomatosis and Renal Cell Carcinoma. Cancer Res 2018; 78:6539-6548. [PMID: 30297534 DOI: 10.1158/0008-5472.can-18-0901] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 07/20/2018] [Accepted: 10/03/2018] [Indexed: 11/16/2022]
Abstract
: Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is an inherited cancer syndrome associated with a highly aggressive form of type 2 papillary renal cell carcinoma (PRCC). Germline inactivating alterations in fumarate hydratase (FH) cause HLRCC and result in elevated levels of reactive oxygen species (ROS). Recent work indicates that FH-/- PRCC cells have increased activation of ABL1, which promotes tumor growth, but how ABL1 is activated remains unclear. Given that oxidation can regulate protein-tyrosine phosphatase (PTP) catalytic activity, inactivation of an ABL-directed PTP by ROS might account for ABL1 activation in this malignancy. Our group previously developed "q-oxPTPome," a method that globally monitors the oxidation of classical PTPs. In this study, we present a refined q-oxPTPome, increasing its sensitivity by >10×. Applying q-oxPTPome to FH-deficient cell models showed that multiple PTPs were either highly oxidized (including PTPN12) or overexpressed. Highly oxidized PTPs were those with relatively high sensitivity to exogenous H2O2. Most PTP oxidation in FH-deficient cells was reversible, although nearly 40% of PTPN13 was irreversibly oxidized to the sulfonic acid state. Using substrate-trapping mutants, we mapped PTPs to their putative substrates and found that only PTPN12 could target ABL1. Furthermore, knockdown experiments identified PTPN12 as the major ABL1 phosphatase, and overexpression of PTPN12 inhibited ABL1 phosphorylation and HLRCC cell growth. These results show that ROS-induced oxidation of PTPN12 accounts for ABL1 phosphorylation in HLRCC-associated PRCC, revealing a novel mechanism for inactivating a tumor suppressor gene product and establishing a direct link between pathologic PTP oxidation and neoplastic disease. SIGNIFICANCE: This work identifies a novel mechanism of activation of the oncogenic kinase ABL1 via ROS-induced, oxidation-mediated inactivation of cognate protein tyrosine phosphatases.
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Affiliation(s)
- Yang Xu
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Laura and Isaac Perlmutter Cancer Center, New York University Langone Medical Center, New York, New York
| | - Paul Taylor
- SPARC BioCentre and Program in Cell Biology, Hospital for Sick Children, Canada
| | - Joshua Andrade
- Proteomics Laboratory, Division of Advanced Research and Technology, NYU Langone Health, New York, New York
| | - Beatrix Ueberheide
- Proteomics Laboratory, Division of Advanced Research and Technology, NYU Langone Health, New York, New York.,Department of Biochemistry and Molecular Pharmacology, NYU Langone Health, New York, New York
| | - Brian Shuch
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Peter M Glazer
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Ranjit S Bindra
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Michael F Moran
- SPARC BioCentre and Program in Cell Biology, Hospital for Sick Children, Canada.,Department of Molecular Genetics, University of Toronto, Canada
| | - W Marston Linehan
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Benjamin G Neel
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada. .,Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Laura and Isaac Perlmutter Cancer Center, New York University Langone Medical Center, New York, New York
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Muller M, Guillaud-Bataille M, Salleron J, Genestie C, Deveaux S, Slama A, de Paillerets BB, Richard S, Benusiglio PR, Ferlicot S. Pattern multiplicity and fumarate hydratase (FH)/S-(2-succino)-cysteine (2SC) staining but not eosinophilic nucleoli with perinucleolar halos differentiate hereditary leiomyomatosis and renal cell carcinoma-associated renal cell carcinomas from kidney tumors without FH gene alteration. Mod Pathol 2018; 31:974-983. [PMID: 29410489 DOI: 10.1038/s41379-018-0017-7] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 12/06/2017] [Accepted: 12/07/2017] [Indexed: 01/22/2023]
Abstract
Hereditary leiomyomatosis and renal cell carcinoma syndrome is characterized by an increased risk of agressive renal cell carcinoma, often of type 2 papillary histology, and is caused by FH germline mutations. A prominent eosinophilic macronucleolus with a perinucleolar clear halo is distinctive of hereditary leiomyomatosis and renal cell carcinoma syndrome-associated renal cell carcinoma according to the 2012 ISUP and 2016 WHO kidney tumor classification. From an immunohistochemistry perspective, tumors are often FH-negative and S-(2-succino)-cysteine (2SC) positive. We performed a pathology review of 24 renal tumors in 23 FH mutation carriers, and compared them to 12 type 2 papillary renal cell carcinomas from FH wild-type patients. Prominent eosinophilic nucleoli with perinucleolar halos were present in almost all FH-deficient renal cell carcinomas (23/24). Unexpectedly, they were also present in 58% of type 2 papillary renal cell carcinomas from wild-type patients. Renal cell carcinoma in mutation carriers displayed a complex architecture with multiple patterns, typically papillary, tubulopapillary, and tubulocystic, but also sarcomatoid and rhabdoid. Such pattern diversity was not seen in non-carriers. FH/2SC immunohistochemistry was informative as all hereditary leiomyomatosis and renal cell carcinoma-associated renal cell carcinomas were either FH- or 2SC+. For FH and 2SC immunohistochemistries taken separately, sensitivity of negative anti-FH immunohistochemistry was 87.5% and specificity was 100%. For positive anti-2SC immunohistochemistry, sensitivity, and specificity were 91.7% and 91.7%, respectively. All FH wild-type renal cell carcinoma were FH-positive, and all but one were 2SC-negative. In conclusion, multiplicity of architectural patterns, rhabdoid/sarcomatoid components and combined FH/2SC staining, but not prominent eosinophilic nucleoli with perinucleolar halos, differentiate hereditary leiomyomatosis and renal cell carcinoma-associated renal cell carcinoma from type 2 papillary renal cell carcinoma with efficient FH gene. Our findings are crucial in identifying who should be referred to Cancer Genetics clinics for genetic counseling and testing.
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Affiliation(s)
- Marie Muller
- Réseau National pour Cancers Rares de l'Adulte PREDIR AP-HP labellisé par l'Institut National du Cancer (INCa), Hôpital de Bicêtre, 94275, Le Kremlin Bicêtre, France. .,Département de Médecine Oncologique, Institut de Cancérologie de Lorraine Alexis Vautrin, 54519, Vandœuvre-lès-Nancy, France.
| | - Marine Guillaud-Bataille
- Département de Biopathologie, Service de Génétique, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
| | - Julia Salleron
- Unité de Biostatistiques, Institut de Cancérologie de Lorraine Alexis Vautrin, 54519, Vandœuvre-lès-Nancy, France
| | - Catherine Genestie
- Département de Biopathologie, Service d'Anatomie-Pathologique, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
| | - Sophie Deveaux
- Réseau National pour Cancers Rares de l'Adulte PREDIR AP-HP labellisé par l'Institut National du Cancer (INCa), Hôpital de Bicêtre, 94275, Le Kremlin Bicêtre, France
| | - Abdelhamid Slama
- Service de Biologie Moléculaire, AP-HP, Hôpital Bicêtre, 94275, Le Kremlin Bicêtre, France
| | | | - Stéphane Richard
- Réseau National pour Cancers Rares de l'Adulte PREDIR AP-HP labellisé par l'Institut National du Cancer (INCa), Hôpital de Bicêtre, 94275, Le Kremlin Bicêtre, France.,Ecole Pratique des Hautes Etudes/PSL Research University, 75014, Paris, France.,Laboratoire de Génétique Oncologique EPHE, INSERM U1186, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France.,Université Paris-Sud, Le Kremlin Bicêtre, France
| | - Patrick R Benusiglio
- Unité Fonctionnelle d'Oncogénétique, Département de Génétique, Groupement Hospitalier La Pitié-Salpêtrière, AP-HP, Paris, France
| | - Sophie Ferlicot
- Réseau National pour Cancers Rares de l'Adulte PREDIR AP-HP labellisé par l'Institut National du Cancer (INCa), Hôpital de Bicêtre, 94275, Le Kremlin Bicêtre, France.,Université Paris-Sud, Le Kremlin Bicêtre, France.,Service d'Anatomie Pathologique, Hôpitaux Universitaires Paris Sud, AP-HP, Le Kremlin Bicêtre, France
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Sims JN, Yedjou CG, Abugri D, Payton M, Turner T, Miele L, Tchounwou PB. Racial Disparities and Preventive Measures to Renal Cell Carcinoma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1089. [PMID: 29843394 PMCID: PMC6024978 DOI: 10.3390/ijerph15061089] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 04/27/2018] [Accepted: 05/01/2018] [Indexed: 02/06/2023]
Abstract
Kidney cancer ranks among the top 10 cancers in the United States. Although it affects both male and female populations, it is more common in males. The prevalence rate of renal cell carcinoma (RCC), which represents about 85% of kidney cancers, has been increasing gradually in many developed countries. Family history has been considered as one of the most relevant risk factors for kidney cancer, although most forms of an inherited predisposition for RCC only account for less than four percent. Lifestyle and other factors such as occupational exposure, high blood pressure, poor diet, and heavy cigarette smoking are highly associated with its incidence and mortality rates. In the United States, White populations have the lowest prevalence of RCC compared to other ethnic groups, while Black Americans suffer disproportionally from the adverse effects of RCC. Hence, this review article aims at identifying the major risk factors associated with RCC and highlighting the new therapeutic approaches for its control/prevention. To achieve this specific aim, articles in peer-reviewed journals with a primary focus on risk factors related to kidney cancer and on strategies to reduce RCC were identified. The review was systematically conducted by searching the databases of MEDLINE, PUBMED Central, and Google Scholar libraries for original articles. From the search, we found that the incidence and mortality rates of RCC are strongly associated with four main risk factors, including family history (genetics), lifestyle (poor diet, cigarette smoking, excess alcohol drinking), environment (community where people live), and occupation (place where people work). In addition, unequal access to improvement in RCC cancer treatment, limited access to screening and diagnosis, and limited access to kidney transplant significantly contribute to the difference observed in survival rate between African Americans and Caucasians. There is also scientific evidence suggesting that some physicians contribute to racial disparities when performing kidney transplant among minority populations. New therapeutic measures should be taken to prevent or reduce RCC, especially among African Americans, the most vulnerable population group.
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Affiliation(s)
- Jennifer N Sims
- Department of Behavioral and Environmental Health, School of Public Health, Jackson State University, 350 W. Woodrow Wilson Dr., P.O. Box 17038, Jackson, MS 39217, USA.
| | - Clement G Yedjou
- Department of Biology, College of Science, Engineering and Technology, Jackson State University, 1400 Lynch St., Jackson, MS 39217, USA.
- Natural Chemotherapeutics Research Laboratory, RCMI Center for Environmental Health, Jackson State University, 1400 Lynch St., Jackson, MS 39217, USA.
| | - Daniel Abugri
- Department of Chemistry and Department of Biology, Laboratory of Ethno-Medicine, Parasitology and Drug Discovery, College of Arts and Science, Tuskegee University, 1200 Old Montgomery Road, Tuskegee, AL 36088, USA.
| | - Marinelle Payton
- Department of Behavioral and Environmental Health, School of Public Health, Jackson State University, 350 W. Woodrow Wilson Dr., P.O. Box 17038, Jackson, MS 39217, USA.
| | - Timothy Turner
- Department of Biology, College of Science, Engineering and Technology, Jackson State University, 1400 Lynch St., Jackson, MS 39217, USA.
| | - Lucio Miele
- Department of Genetics, Louisiana State University, Health Sciences Center, School of Medicine, 533 Bolivar St., Room 657, New Orleans, LA 70112, USA.
| | - Paul B Tchounwou
- Natural Chemotherapeutics Research Laboratory, RCMI Center for Environmental Health, Jackson State University, 1400 Lynch St., Jackson, MS 39217, USA.
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Molecular profiling of renal cell carcinoma: building a bridge toward clinical impact. Curr Opin Urol 2018; 26:383-7. [PMID: 27467134 DOI: 10.1097/mou.0000000000000307] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW The daunting task of identifying key molecular drivers of renal cell carcinoma (RCC) has begun to reveal significant insights into tumor biology. This review provides an update on recent discoveries in this field and their possible clinical implications. RECENT FINDINGS Molecular profiles within the classic RCC histologic subtypes present distinctive appreciation of tumor biology and also allow for exploitation of targeted treatment regimens for patients with metastatic disease. Prognostic signatures have demonstrated the ability to accurately predict many clinical outcomes. SUMMARY The molecular and genomic profiling of RCC subtypes has identified a unique and diverse spectrum of alterations. Utilization of these characteristics to improve our prognostic and therapeutic outcomes in the clinical realm remains in its infancy but is rapidly advancing.
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Schultz KAP, Rednam SP, Kamihara J, Doros L, Achatz MI, Wasserman JD, Diller LR, Brugières L, Druker H, Schneider KA, McGee RB, Foulkes WD. PTEN, DICER1, FH, and Their Associated Tumor Susceptibility Syndromes: Clinical Features, Genetics, and Surveillance Recommendations in Childhood. Clin Cancer Res 2018; 23:e76-e82. [PMID: 28620008 DOI: 10.1158/1078-0432.ccr-17-0629] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 04/24/2017] [Accepted: 04/27/2017] [Indexed: 11/16/2022]
Abstract
PTEN hamartoma tumor syndrome (PHTS), DICER1 syndrome, and hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome are pleiotropic tumor predisposition syndromes that include benign and malignant neoplasms affecting adults and children. PHTS includes several disorders with shared and distinct clinical features. These are associated with elevated lifetime risk of breast, thyroid, endometrial, colorectal, and renal cancers as well as melanoma. Thyroid cancer represents the predominant cancer risk under age 20 years. DICER1 syndrome includes risk for pleuropulmonary blastoma, cystic nephroma, ovarian sex cord-stromal tumors, and multinodular goiter and thyroid carcinoma as well as brain tumors including pineoblastoma and pituitary blastoma. Individuals with HLRCC may develop multiple cutaneous and uterine leiomyomas, and they have an elevated risk of renal cell carcinoma. For each of these syndromes, a summary of the key syndromic features is provided, the underlying genetic events are discussed, and specific screening is recommended. Clin Cancer Res; 23(12); e76-e82. ©2017 AACRSee all articles in the online-only CCR Pediatric Oncology Series.
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Affiliation(s)
- Kris Ann P Schultz
- International Pleuropulmonary Blastoma Registry, Cancer and Blood Disorders, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota
| | - Surya P Rednam
- Department of Pediatrics, Baylor College of Medicine, Texas Children's Cancer Center, Texas Children's Hospital, Houston, Texas
| | - Junne Kamihara
- Boston Children's Hospital, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Leslie Doros
- Cancer Genetics Clinic, Children's National Medical Center, Washington, DC
| | | | - Jonathan D Wasserman
- Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lisa R Diller
- Boston Children's Hospital, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Laurence Brugières
- Child and Adolescent Cancer Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Harriet Druker
- Division of Hematology/Oncology and Department of Genetic Counselling, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Katherine A Schneider
- Pediatric Cancer Genetic Risk Program, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Rose B McGee
- Department of Oncology, Division of Cancer Predisposition, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - William D Foulkes
- Department of Human Genetics and Research Institute, McGill University Health Centre, McGill University, Montreal, Québec, Canada.
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72
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Matson DR, Accola MA, Rehrauer WM, Huang W. An atypical case of Hereditary Leiomyomatosis and Renal Cell Cancer (HLRCC)-associated renal cell carcinoma identified by next-generation sequencing. HUMAN PATHOLOGY: CASE REPORTS 2018. [DOI: 10.1016/j.ehpc.2017.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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73
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Moch H, Ohashi R, Gandhi JS, Amin MB. Morphological clues to the appropriate recognition of hereditary renal neoplasms. Semin Diagn Pathol 2018; 35:184-192. [PMID: 29454577 DOI: 10.1053/j.semdp.2018.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
An important emerging role of the surgical pathologist besides the traditional tasks of establishment of the diagnosis and documentation of prognostic and predictive factors, is to recognize the possibility of a hereditary condition in cases where the histology is suggestive for a familial cancer syndrome. In recent years, the knowledge regarding all of the above roles, including the role of recognition of familial cancer, has particularly expanded in renal neoplasms with the close scrutiny to morphology, molecular correlates and clinical features of the different sub-types of renal cell carcinoma. Awareness of these clinically distinctive sub-types and their associated histologic clues will prompt the pathologist for further immunohistochemical or molecular work up, to look for clinical information to support the suspected diagnosis of familial cancer, to alert managing physician/s to look for stigmata of history of familial cancer, which will permit triaging patients and their families for appropriate genetic counseling. This review provides a comprehensive review of the known sub-types of renal cell carcinoma that have a predilection to occur in the setting of hereditary disease; examples include renal cancers occurring in the background of von Hippel Lindau disease, hereditary leiomyomatosis and renal cell carcinoma syndrome, tuberous sclerosis, Birt Hogg Dube syndrome and succinate dehydrogenase deficiency. Herein we focus on diagnostic clues for renal tumors occurring in a non-pediatric setting that should prompt their correct recognition and reiterate the importance of the correct diagnosis.
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Affiliation(s)
- Holger Moch
- Department of Pathology and Molecular Pathology, University and University Hospital Zurich, Switzerland.
| | - Riuko Ohashi
- Histopathology Core Facility, Niigata University Faculty of Medicine, Niigata, Japan; Division of Molecular and Diagnostic Pathology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Jatin S Gandhi
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Sciences, Memphis, USA
| | - Mahul B Amin
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Sciences, Memphis, USA; Department of Urology, University of Tennessee Health Sciences, Memphis, USA
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74
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Abstract
Papillary renal cell carcinomas (PRCC) are a histologically and genetically heterogeneous group of tumors that represent 15–20% of all kidney neoplasms and may require diverse therapeutic approaches. Alteration of the NF2 tumor suppressor gene, encoding a key regulator of the Hippo signaling pathway, is observed in 22.5% of PRCC. The Hippo signaling pathway controls cell proliferation by regulating the transcriptional activity of Yes-Associated Protein, YAP1. Loss of NF2 results in aberrant YAP1 activation. The Src family kinase member Yes also regulates YAP1 transcriptional activity. This study investigated the importance of YAP and Yes activity in three NF2-deficient PRCC cell lines. NF2-deficency correlated with increased expression of YAP1 transcriptional targets and siRNA-based knockdown of YAP1 and Yes1 downregulated this pathway and dramatically reduced cell viability. Dasatinib and saracatinib have potent inhibitory effects on Yes and treatment with either resulted in downregulation of YAP1 transcription targets, reduced cell viability, and G0-G1 cell cycle arrest. Xenograft models for NF2-deficient PRCC also demonstrated reduced tumor growth in response to dasatinib. Thus, inhibiting Yes and the subsequent transcriptional activity of YAP1 had a substantial anti-tumor cell effect both in vitro and in vivo and may provide a viable therapeutic approach for patients with NF2-deficient PRCC.
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75
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Almassi N, Gorin MA, Purysko AS, Rowe SP, Kaouk J, Allaf ME, Campbell SC, Rhee A. Use of 99mTc-sestamibi Single-photon Emission Computed Tomography / X-ray Computed Tomography in the Diagnosis of Hybrid Oncocytic / Chromophobe Tumor in a Pediatric Patient. Urology 2017; 113:206-208. [PMID: 29174943 DOI: 10.1016/j.urology.2017.11.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 09/19/2017] [Accepted: 11/11/2017] [Indexed: 01/06/2023]
Abstract
The differential diagnosis of solid renal neoplasms in adolescence includes aggressive malignancy and indolent oncocytic tumors, which are typically indistinguishable using conventional imaging. We report the use of 99mTc-sestamibi single-photon emission computed tomography / x-ray computed tomography (SPECT/CT) in characterizing enhancing renal neoplasms in a pediatric patient. Genetic testing suggested a hereditary syndrome associated with aggressive malignancy, whereas renal mass biopsy suggested an oncocytic tumor. 99mTc-sestamibi SPECT/CT indicated probable oncocytomas or hybrid oncocytic / chomophobe tumors. Enucleative resection was performed with final pathology demonstrating hybrid oncocytic / chomophobe tumors. This case highlights the potential utility of 99mTc-sestamibi SPECT/CT in characterizing indeterminate enhancing renal neoplasm in pediatric patients.
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Affiliation(s)
- Nima Almassi
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH; Lerner College of Medicine, Education Institute, Cleveland Clinic, Cleveland, OH
| | - Michael A Gorin
- The James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD; The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Andrei S Purysko
- Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH
| | - Steven P Rowe
- The James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD; The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jihad Kaouk
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH
| | - Mohamad E Allaf
- The James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Steven C Campbell
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH
| | - Audrey Rhee
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH.
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Abstract
Renal cell carcinoma (RCC) exhibits a diverse and heterogeneous disease spectrum, but insight into its molecular biology has provided an improved understanding of potential risk factors, oncologic behavior, and imaging features. Computed tomography (CT) and MR imaging may allow the identification and preoperative subtyping of RCC and assessment of a response to various therapies. Active surveillance is a viable management option in some patients and has provided further insight into the natural history of RCC, including the favorable prognosis of cystic neoplasms. This article reviews CT and MR imaging in RCC and the role of screening in selected high-risk populations.
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Affiliation(s)
- Alberto Diaz de Leon
- Department of Radiology, University of Texas Southwestern Medical Center, 2201 Inwood Road, 2nd Floor, Suite 202, Dallas, TX 75390-9085, USA
| | - Ivan Pedrosa
- Department of Radiology, University of Texas Southwestern Medical Center, 2201 Inwood Road, 2nd Floor, Suite 202, Dallas, TX 75390-9085, USA.
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77
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Inamura K. Renal Cell Tumors: Understanding Their Molecular Pathological Epidemiology and the 2016 WHO Classification. Int J Mol Sci 2017; 18:E2195. [PMID: 29053609 PMCID: PMC5666876 DOI: 10.3390/ijms18102195] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/14/2017] [Accepted: 10/17/2017] [Indexed: 02/06/2023] Open
Abstract
Accumulating evidence suggests that renal cell tumors represent a group of histologically and molecularly heterogeneous diseases, even within the same histological subtype. In accordance with the increased understanding of the morphological, immunohistochemical, molecular, and epidemiological characteristics of renal cell tumors, the World Health Organization (WHO) classification of renal cell tumors has been modified. This review provides perspectives on both new and current subtypes of renal cell tumors, as well as on the emerging/provisional renal cell carcinomas in the new 2016 WHO classification, which focuses on features of their molecular pathological epidemiology. The WHO classification will require additional revisions to enable the classification of renal cell tumors as clinically meaningful subtypes and provide a better understanding of the unique characteristics of renal cell tumors.
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Affiliation(s)
- Kentaro Inamura
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan.
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78
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Abstract
The study of hereditary forms of kidney cancer has vastly increased our understanding of metabolic and genetic pathways involved in the development of both inherited and sporadic kidney cancers. The recognition that diverse molecular events drive different forms of kidney cancers has led to the preclinical and clinical development of specific pathway-directed strategies tailored to treat distinct subgroups of kidney cancer. Here, we describe the molecular mechanisms underlying the pathogenesis of several different types of hereditary renal cancers, review their clinical characteristics, and summarize the treatment strategies for the management of these cancers.
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Affiliation(s)
- Abhinav Sidana
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Building 10 - Hatfield CRC, Room 1-5940, Bethesda, MD, 20892, USA.
| | - Ramaprasad Srinivasan
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Building 10 - Hatfield CRC, Room 1-5940, Bethesda, MD, 20892, USA
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79
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Renal Cell Carcinoma With Chromosome 6p Amplification Including the TFEB Gene: A Novel Mechanism of Tumor Pathogenesis? Am J Surg Pathol 2017; 41:287-298. [PMID: 28009604 DOI: 10.1097/pas.0000000000000776] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Amplification of chromosome 6p has been implicated in aggressive behavior in several cancers, but has not been characterized in renal cell carcinoma (RCC). We identified 9 renal tumors with amplification of chromosome 6p including the TFEB gene, 3 by fluorescence in situ hybridization, and 6 from the Cancer Genome Atlas (TCGA) databases. Patients' ages were 28 to 78 years (median, 61 y). Most tumors were high stage (7/9 pT3a, 2/9 pN1). Using immunohistochemistry, 2/4 were positive for melanocytic markers and cathepsin K. Novel TFEB fusions were reported by TCGA in 2; however, due to a small composition of fusion transcripts compared with full-length transcripts (0.5/174 and 3.3/132 FPKM), we hypothesize that these represent secondary fusions due to amplification. Five specimens (4 TCGA, 1 fluorescence in situ hybridization) had concurrent chromosome 3p copy number loss or VHL deletion. However, these did not resemble clear cell RCC, had negative carbonic anhydrase IX labeling, lacked VHL mutation, and had papillary or unclassified histology (2/4 had gain of chromosome 7 or 17). One tumor each had somatic FH mutation and SMARCB1 mutation. Chromosome 6p amplification including TFEB is a previously unrecognized cytogenetic alteration in RCC, associated with heterogenous tubulopapillary eosinophilic and clear cell histology. The combined constellation of features does not fit cleanly into an existing tumor category (unclassified), most closely resembling papillary or translocation RCC. The tendency for high tumor stage, varied tubulopapillary morphology, and a subset with melanocytic marker positivity suggests the possibility of a unique tumor type, despite some variation in appearance and genetics.
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80
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Fumarate Hydratase-deficient Renal Cell Carcinoma Is Strongly Correlated With Fumarate Hydratase Mutation and Hereditary Leiomyomatosis and Renal Cell Carcinoma Syndrome. Am J Surg Pathol 2017; 40:865-75. [PMID: 26900816 DOI: 10.1097/pas.0000000000000617] [Citation(s) in RCA: 165] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hereditary leiomyomatosis and renal cell carcinoma syndrome-associated renal cell carcinomas (RCC) are difficult to diagnose prospectively. We used immunohistochemistry (IHC) to identify fumarate hydratase (FH)-deficient tumors (defined as FH negative, 2-succinocysteine [2SC] positive) in cases diagnosed as "unclassified RCC, high grade or with papillary pattern," or "papillary RCC type 2," from multiple institutions. A total of 124 tumors (from 118 patients) were evaluated by IHC for FH and 2SC. An FH deficiency was found in 24/124 (19%) cases. An indeterminate result (only 1 marker abnormal) was found in 27/124 (22%) cases. In a tissue microarray of 776 RCCs of different types, only 2 (0.5%) tumors, initially considered papillary type 2, were FH deficient. FH mutations were found in 19/21 FH-deficient tumors (with confirmed germline mutations in 9 of 9 tumors in which germline status could be assessed) and in 1/26 FH-indeterminate tumors identified by IHC. No FH mutations were found in 2/21 FH-deficient RCCs, 25/26 FH-indeterminate RCCs, and 10/10 RCCs demonstrating FH expression by IHC. Patients with FH-deficient RCC had a median age of 44 years (range, 21 to 65 y). Average tumor size was 8.2 cm (range, 0.9 to 18 cm). FH-deficient RCCs were characterized by at least focal macronucleoli and demonstrated 2 or more growth patterns in 93% cases. Papillary was the most common (74%) and dominant (59%) pattern, whereas other common patterns included: solid (44%), tubulocystic (41%), cribriform (41%), and cystic (33%). At presentation, 57% were stage ≥pT3, 52% had positive nodes, and 19% had distant metastases. After a mean follow-up of 27 months (range, 1 to 114 mo), 39% of patients were dead of disease, and 26% had disease progression. We conclude that FH and 2SC are useful IHC ancillary tools, which allow recognition of FH-deficient RCC.
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81
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Renal cell cancers: unveiling the hereditary ones and saving lives—a tailored diagnostic approach. Int Urol Nephrol 2017; 49:1507-1512. [DOI: 10.1007/s11255-017-1625-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 05/18/2017] [Indexed: 10/19/2022]
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82
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Muller M, Ferlicot S, Guillaud-Bataille M, Le Teuff G, Genestie C, Deveaux S, Slama A, Poulalhon N, Escudier B, Albiges L, Soufir N, Avril MF, Gardie B, Saldana C, Allory Y, Gimenez-Roqueplo AP, Bressac-de Paillerets B, Richard S, Benusiglio P. Reassessing the clinical spectrum associated with hereditary leiomyomatosis and renal cell carcinoma syndrome in French FH
mutation carriers. Clin Genet 2017; 92:606-615. [DOI: 10.1111/cge.13014] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 03/02/2017] [Accepted: 03/13/2017] [Indexed: 12/17/2022]
Affiliation(s)
- M. Muller
- Réseau Expert National pour Cancers Rares de l'Adulte PREDIR AP-HP/INCa; Hôpital Bicêtre; Le Kremlin-Bicêtre France
- Ecole Pratique des Hautes Etudes F-75014 Paris, Laboratoire de Génétique Oncologique EPHE, INSERM U1186, Gustave Roussy; Université Paris-Saclay; Villejuif France
- Faculté de Médecine Université Paris-Sud; Le Kremlin-Bicêtre France
- Département de Médecine Oncologique; Institut de Cancérologie de Lorraine Alexis Vautrin; Nancy France
| | - S. Ferlicot
- Réseau Expert National pour Cancers Rares de l'Adulte PREDIR AP-HP/INCa; Hôpital Bicêtre; Le Kremlin-Bicêtre France
- Service d'Anatomie Pathologique; Hôpitaux Universitaires Paris Sud, AP-HP; Le Kremlin-Bicêtre France
| | - M. Guillaud-Bataille
- Département de Biopathologie, Service de Génétique, Gustave Roussy; Université Paris-Saclay; Villejuif France
| | - G. Le Teuff
- Unité de Biostatistiques et d'Epidémiologie, Gustave Roussy; Université Paris-Saclay; Villejuif France
- INSERM U1018, CESP; Université Paris-Saclay; Villejuif France
| | - C. Genestie
- Département de Biopathologie, Service d‘Anatomie-Pathologique, Gustave Roussy; Université Paris-Saclay; Villejuif France
| | - S. Deveaux
- Réseau Expert National pour Cancers Rares de l'Adulte PREDIR AP-HP/INCa; Hôpital Bicêtre; Le Kremlin-Bicêtre France
| | - A. Slama
- Service de Biologie Moléculaire, AP-HP; Hôpital Bicêtre; Le Kremlin-Bicêtre France
| | - N. Poulalhon
- Service de Dermatologie; Centre Hospitalier Lyon Sud; Lyon France
| | - B. Escudier
- Réseau Expert National pour Cancers Rares de l'Adulte PREDIR AP-HP/INCa; Hôpital Bicêtre; Le Kremlin-Bicêtre France
- Département de Médecine Oncologique, Gustave Roussy; Université Paris-Saclay; Villejuif France
| | - L. Albiges
- Département de Médecine Oncologique, Gustave Roussy; Université Paris-Saclay; Villejuif France
| | - N. Soufir
- Département de Génétique Moléculaire; Hôpital Bichat-Claude Bernard; Paris France
| | - M.-F. Avril
- Réseau Expert National pour Cancers Rares de l'Adulte PREDIR AP-HP/INCa; Hôpital Bicêtre; Le Kremlin-Bicêtre France
- Service de Dermatologie, Hôpital Cochin, AP-HP; Paris France
- Faculté de Médecine; Université Paris Descartes, Sorbonne Paris Cité; Paris France
| | - B. Gardie
- Ecole Pratique des Hautes Etudes F-75014 Paris, Laboratoire de Génétique Oncologique EPHE, INSERM U1186, Gustave Roussy; Université Paris-Saclay; Villejuif France
- Faculté de Médecine Université Paris-Sud; Le Kremlin-Bicêtre France
- Inserm UMR 892, CNRS UMR 6299, Centre de Recherche en Cancérologie Nantes-Angers, Institut de Recherche en Santé; Université de Nantes; Nantes France
| | - C. Saldana
- Service d'Oncologie Médicale; Hôpital Henri Mondor; Créteil France
| | - Y. Allory
- Service d'Anatomie-Pathologique; Hôpital Henri Mondor, AP-HP; Créteil France
| | - A.-P. Gimenez-Roqueplo
- Réseau Expert National pour Cancers Rares de l'Adulte PREDIR AP-HP/INCa; Hôpital Bicêtre; Le Kremlin-Bicêtre France
- Faculté de Médecine; Université Paris Descartes, Sorbonne Paris Cité; Paris France
- Centre de Recherche Cardiovasculaire, INSERM, UMR970; Hôpital Européen Georges Pompidou, AP-HP; Paris France
- Service de Génétique, Hôpital Européen Georges Pompidou, AP-HP; Paris France
| | - B. Bressac-de Paillerets
- Département de Biopathologie, Service de Génétique, Gustave Roussy; Université Paris-Saclay; Villejuif France
| | - S. Richard
- Réseau Expert National pour Cancers Rares de l'Adulte PREDIR AP-HP/INCa; Hôpital Bicêtre; Le Kremlin-Bicêtre France
- Ecole Pratique des Hautes Etudes F-75014 Paris, Laboratoire de Génétique Oncologique EPHE, INSERM U1186, Gustave Roussy; Université Paris-Saclay; Villejuif France
- Faculté de Médecine Université Paris-Sud; Le Kremlin-Bicêtre France
| | - P.R. Benusiglio
- Département de Médecine Oncologique, Gustave Roussy; Université Paris-Saclay; Villejuif France
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83
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Lee CH, Gundem G, Lee W, Chen YB, Cross JR, Dong Y, Redzematovic A, Mano R, Wei EY, Cheng EH, Srinivasan R, Oschwald D, Hakimi AA, Dunphy MP, Linehan WM, Papaemmanuil E, Hsieh JJ. Persistent Severe Hyperlactatemia and Metabolic Derangement in Lethal SDHB-Mutated Metastatic Kidney Cancer: Clinical Challenges and Examples of Extreme Warburg Effect. JCO Precis Oncol 2017; 1:PO.16.00007. [PMID: 35172488 PMCID: PMC9797236 DOI: 10.1200/po.16.00007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
To describe the unique clinical features, determine the genomics, and investigate the metabolic derangement of an extremely rare form of a hereditary lethal kidney cancer syndrome. Patients and Methods Three patients with lethal kidney cancer (age 19, 20, and 37 years) exhibiting persistent (1 to 3 months) extremely high levels of blood lactate (> 5 mM) despite normal oxygen perfusion, highly avid tumors on [18F]fluorodeoxyglucose positron emission tomography (PET), and pleomorphic histopathologic features were identified and treated in a single institute. Integrated studies including whole-genome sequencing (WGS), targeted sequencing, immunohistochemistry, cell-based assays, and 18F-glutamine PET imaging were performed to investigate this rare kidney cancer syndrome. Results All three patients with kidney cancer were initially given various diagnoses as a result of diverse tumor histopathology and atypical clinical presentations. The correct diagnoses of these SDHB-mutated renal cell carcinomas were first made based on cancer genomics. Genomic studies of the blood and tumors of these patients identified three different kinds of germline loss-of-function mutations in the SDHB gene and the common loss of heterozygosity in the remaining SDHB allele thorough somatic chromosome 1p deletion. In one patient, WGS revealed that a germline mutation of SDHB coupled with loss of heterozygosity was the sole genetic event. Cancer evolution analysis of SDHB tumors based on WGS demonstrated that SDHB in kidney epithelium fulfills the Knudson two-hit criteria as a major tumor suppressor gene. SDHB -/- tumor cells displayed increase in glucose uptake and lactate production, alteration in mitochondrial architecture, and defect in oxidative respiration. 18F-Glutamine PET imaging studies demonstrated increased glutamine metabolism. Conclusion SDHB-deficient metastatic renal cell carcinoma is a rare, aggressive form of kidney cancer that manifests with clinical evidence of a severe Warburg effect, and genomic studies demonstrated two genetic hits at SDHB genes during kidney tumorigenesis.
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Affiliation(s)
- Chung-Han Lee
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Gunes Gundem
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - William Lee
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Ying-Bei Chen
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Justin R. Cross
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Yiyu Dong
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Almedina Redzematovic
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Roy Mano
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Elizabeth Y. Wei
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Emily H. Cheng
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Ramaprasad Srinivasan
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Dayna Oschwald
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - A. Ari Hakimi
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Mark P. Dunphy
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - W. Marston Linehan
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Elli Papaemmanuil
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - James J. Hsieh
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
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84
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Daugherty M, Sedaghatpour D, Shapiro O, Vourganti S, Kutikov A, Bratslavsky G. The metastatic potential of renal tumors: Influence of histologic subtypes on definition of small renal masses, risk stratification, and future active surveillance protocols. Urol Oncol 2017; 35:153.e15-153.e20. [DOI: 10.1016/j.urolonc.2016.11.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 11/06/2016] [Accepted: 11/13/2016] [Indexed: 12/25/2022]
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85
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Vocke CD, Ricketts CJ, Merino MJ, Srinivasan R, Metwalli AR, Middelton LA, Peterson J, Yang Y, Linehan WM. Comprehensive genomic and phenotypic characterization of germline FH deletion in hereditary leiomyomatosis and renal cell carcinoma. Genes Chromosomes Cancer 2017; 56:484-492. [PMID: 28196407 DOI: 10.1002/gcc.22452] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 12/14/2022] Open
Abstract
Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is a familial cancer syndrome associated with the development of cutaneous and uterine leiomyomas, and an aggressive form of type 2 papillary kidney cancer. HLRCC is characterized by germline mutation of the FH gene. This study evaluated the prevalence and clinical phenotype of FH deletions in HLRCC patients. Patients with phenotypic manifestations consistent with HLRCC who lacked detectable germline FH intragenic mutations were investigated for FH deletion. A series of 28 patients from 13 families were evaluated using a combination of a comparative genomic hybridization (CGH) array and/or CLIA-approved FH deletion/duplication analyses. Thirteen distinct germline deletions were identified in the 13 UOB families, including 11 complete FH gene deletions and 2 partial FH gene deletions. The size of eight evaluated complete FH deletions varied from ∼4.74 Mb to 249 kb, with all deletions resulting in additional gene losses. Two partial FH gene deletions were identified, with one resulting in loss of exon 1 and the upstream region of the FH gene only. Kidney cancer was diagnosed in 9 (32%) of 28 patients and 7 (54%) of 13 families possessing either complete or partial FH deletions. Cutaneous and uterine leiomyomas were observed at similar rates to those in FH point mutation families. Complete or partial FH gene alterations in HLRCC families are associated with all of the canonical HLRCC manifestations, including type 2 papillary kidney cancer and should be screened for in any patient at-risk for this disorder.
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Affiliation(s)
- Cathy D Vocke
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Christopher J Ricketts
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Maria J Merino
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Ramaprasad Srinivasan
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Adam R Metwalli
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Lindsay A Middelton
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.,Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, Inc, NCI Campus at Frederick, Frederick, Maryland, USA
| | - James Peterson
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Youfeng Yang
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - W Marston Linehan
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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86
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Hereditary leiomyomatosis and renal cell cancer syndrome: An update and review. J Am Acad Dermatol 2017; 77:149-158. [PMID: 28314682 DOI: 10.1016/j.jaad.2017.01.023] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 01/07/2017] [Accepted: 01/11/2017] [Indexed: 02/06/2023]
Abstract
Hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome is a rare genetic disorder that predisposes individuals to multiple cutaneous leiomyomas, renal cell carcinomas, and in women, uterine leiomyomas. Also known as Reed syndrome, it is caused by a germline heterozygous mutation of the fumarate hydratase tumor suppressor gene. HLRCC is associated with significant morbidity because of pain from cutaneous and uterine leiomyomas, the cutaneous pain often of unique character. Although genetic testing is currently considered the criterion standard to diagnose HLRCC, newer immunohistochemistry markers may provide rapid and cost effective alternatives to genetic testing. Because of the potentially aggressive nature of renal cell carcinomas that develop as early as in childhood, close annual cancer surveillance is desirable in individuals with HLRCC. In this review, we offer an update and an approach to the diagnosis, management, and renal cancer surveillance in HLRCC.
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87
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Clinicopathologic and Molecular Pathology of Collecting Duct Carcinoma and Related Renal Cell Carcinomas. Adv Anat Pathol 2017; 24:65-77. [PMID: 28181950 DOI: 10.1097/pap.0000000000000138] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Collecting duct carcinoma (CDC) and related tumors [ie, renal medullary carcinoma (RMC)] are rare types of highly aggressive renal cell carcinomas (RCC) with poor prognosis. Because of the rarity and diagnostic uncertainty of them, their molecular pathology and significance have not yet been fully elucidated. CDC, RMC, fumarate hydratase-deficient RCC (including hereditary leiomyomatosis and RCC-associated RCC HLRCC-RCC), and recently reported anaplastic lymphoma kinase (ALK)-rearrangement RCC have significant morphologic overlaps, but they are separately distinct entities having different molecular pathway and clinical settings. CDC is more likely to occur in middle to old age population with immunoreactivity for PAX8 and integrase interactor-1 proteins (INI-1). Various chromosomal and genomic alterations have been reported with inconsistent results. In contrast, RMC is more likely to occur in younger patients with sickle cell trait. In RMC, loss of INI-1 expression and OCT3/4 expression are distinguished compared with other RCCs. Finally, ALK-rearrangement RCC seems to have 2 different clinical settings, one with sickle cell trait (VCL-ALK fusion) and the other without (other fusions such as TPM3-ALK, EML4-ALK, and STRN-ALK fusions). Interestingly, VCL-ALK fusion was found in pediatric patients with sickle cell trait, whereas other fusions were detected in adolescent or adult without sickle cell trait. Taken together, CDC and related tumors such as RMC, fumarate hydratase-deficient RCC (including hereditary leiomyomatosis and RCC-associated RCC), and ALK-rearrangement RCC are the distinct entities and their recognition is important for the development of future personalized therapeutic options. This review updates the clinicopathologic features of these tumors with overlapping morphology and outcome.
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88
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Kopp RP, Stratton KL, Glogowski E, Schrader KA, Rau-Murthy R, Russo P, Coleman JA, Offit K. Utility of prospective pathologic evaluation to inform clinical genetic testing for hereditary leiomyomatosis and renal cell carcinoma. Cancer 2017; 123:2452-2458. [DOI: 10.1002/cncr.30605] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/18/2016] [Accepted: 12/29/2016] [Indexed: 01/22/2023]
Affiliation(s)
- Ryan P. Kopp
- Urology Service, Department of Surgery; Memorial Sloan Kettering Cancer Center; New York New York
| | - Kelly L. Stratton
- Urology Service, Department of Surgery; Memorial Sloan Kettering Cancer Center; New York New York
| | - Emily Glogowski
- Clinical Genetics Service, Department of Medicine; Memorial Sloan Kettering Cancer Center; New York New York
| | - Kasmintan A. Schrader
- Clinical Genetics Service, Department of Medicine; Memorial Sloan Kettering Cancer Center; New York New York
| | - Rohini Rau-Murthy
- Clinical Genetics Service, Department of Medicine; Memorial Sloan Kettering Cancer Center; New York New York
| | - Paul Russo
- Urology Service, Department of Surgery; Memorial Sloan Kettering Cancer Center; New York New York
| | - Jonathan A. Coleman
- Urology Service, Department of Surgery; Memorial Sloan Kettering Cancer Center; New York New York
| | - Kenneth Offit
- Clinical Genetics Service, Department of Medicine; Memorial Sloan Kettering Cancer Center; New York New York
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89
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[WHO classification 2016 and first S3 guidelines on renal cell cancer: What is important for the practice?]. DER PATHOLOGE 2017; 37:127-33. [PMID: 26942728 DOI: 10.1007/s00292-016-0144-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The first S3 guidelines on renal cell cancer cover the practical aspects of imaging, diagnostics and therapy as well as the clinical relevance of pathology reporting. This review summarizes the changes in renal tumor classification and the new recommendations for reporting renal cell tumors. The S3 guidelines recommend the 2016 World Health Organization (WHO) classification of renal cell tumors. Novel renal cell tumor entities and provisional or emerging renal cell tumor entities of the 2016 WHO classification of renal tumors are discussed. The S3 guidelines for renal cell cancer also recommend the use of the WHO/International Society of Urologic Pathology (ISUP) grading system for clear cell and for papillary renal cell carcinomas, which replaces the previously used Fuhrman grading system.
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90
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91
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Gaur S, Turkbey B, Choyke P. Hereditary Renal Tumor Syndromes: Update on Diagnosis and Management. Semin Ultrasound CT MR 2016; 38:59-71. [PMID: 28237281 DOI: 10.1053/j.sult.2016.10.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Hereditary renal cancers account for approximately 5%-8% of all renal tumors. Over the past 2 decades, a number of syndromes have been identified that predispose patients to early renal cancer development, representing all the major histologic types of tumor pathology. In this article, we describe the current knowledge concerning the cell type, known mechanism of tumor development, other manifestations of the syndrome, imaging findings, genetic screening, and imaging surveillance recommendations for each of the major syndromes associated with hereditary renal cancers.
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Affiliation(s)
- Sonia Gaur
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Baris Turkbey
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Peter Choyke
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD.
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92
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Riazalhosseini Y, Lathrop M. Precision medicine from the renal cancer genome. Nat Rev Nephrol 2016; 12:655-666. [DOI: 10.1038/nrneph.2016.133] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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93
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Abstract
Kidney cancer is not a single disease but is made up of a number of different types of cancer classified by histology that are disparate in presentation, clinical course, and genetic basis. Studies of families with inherited renal cell carcinoma (RCC) have provided the basis for our understanding of the causative genes and altered metabolic pathways in renal cancer with different histologies. Von Hippel-Lindau disease was the first renal cancer disorder with a defined genetic basis. Over the next two decades, the genes responsible for a number of other inherited renal cancer syndromes including hereditary papillary renal carcinoma, Birt-Hogg-Dube´syndrome, hereditary leiomyomatosis and renal cell carcinoma, and succinate dehydrogenase-associated renal cancer were identified. Recently, renal cell carcinoma has been confirmed as part of the clinical phenotype in individuals from families with BAP1-associated tumor predisposition syndrome and MiTF-associated cancer syndrome. Here we summarize the clinical characteristics of and causative genes for these and other inherited RCC syndromes, the pathways that are dysregulated when the inherited genes are mutated, and recommended clinical management of patients with these inherited renal cancer syndromes.
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Affiliation(s)
- Laura S Schmidt
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD; Basic Science Program, Leidos Biomedical Research, Inc, Frederick National Laboratory for Cancer Research, Frederick, MD
| | - W Marston Linehan
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD.
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94
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Management of renal cell carcinoma in young patients and patients with hereditary syndromes. Curr Opin Urol 2016; 26:396-404. [DOI: 10.1097/mou.0000000000000322] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ciccarese C, Di Nunno V, Montironi R, Fiorentino M, Brunelli M, Tortora G, Ardizzoni A, Massari F. The role of precision medicine for the treatment of metastatic renal cell carcinoma. EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT 2016. [DOI: 10.1080/23808993.2016.1214057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Chiara Ciccarese
- Medical Oncology, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy
| | - Vincenzo Di Nunno
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Sant’Orsola-Malpighi Hospital, Bologna, Italy
| | - Rodolfo Montironi
- Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, AOU Ospedali Riuniti, Ancona, Italy
| | - Michelangelo Fiorentino
- Pathology Service, Addarii Institute of Oncology, S-Orsola-Malpighi Hospital, Bologna, Italy
| | - Matteo Brunelli
- Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata (AOUI), University of Verona, Verona, Italy
| | - Giampaolo Tortora
- Medical Oncology, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy
| | - Andrea Ardizzoni
- Division of Oncology, S.Orsola-Malpighi Hospital, Bologna, Italy
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Ciccarese C, Brunelli M, Montironi R, Fiorentino M, Iacovelli R, Heng D, Tortora G, Massari F. The prospect of precision therapy for renal cell carcinoma. Cancer Treat Rev 2016; 49:37-44. [PMID: 27453294 DOI: 10.1016/j.ctrv.2016.07.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 07/01/2016] [Accepted: 07/04/2016] [Indexed: 02/01/2023]
Abstract
The therapeutic landscape of renal cell carcinoma (RCC) has greatly expanded in the last decade. From being a malignancy orphan of effective therapies, kidney cancer has become today a tumor with several treatment options. Renal cell carcinoma (RCC) is a metabolic disease, being characterized by the dysregulation of metabolic pathways involved in oxygen sensing (VHL/HIF pathway alterations and the subsequent up-regulation of HIF-responsive genes such as VEGF, PDGF, EGF, and glucose transporters GLUT1 and GLUT4, which justify the RCC reliance on aerobic glycolysis), energy sensing (fumarate hydratase-deficient, succinate dehydrogenase-deficient RCC, mutations of HGF/MET pathway resulting in the metabolic Warburg shift marked by RCC increased dependence on aerobic glycolysis and the pentose phosphate shunt, augmented lipogenesis, and reduced AMPK and Krebs cycle activity) and/or nutrient sensing cascade (deregulation of AMPK-TSC1/2-mTOR and PI3K-Akt-mTOR pathways). In this complex scenario it is important to find prognostic and predictive factors that can help in decision making in the treatment of mRCC.
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Affiliation(s)
- Chiara Ciccarese
- Medical Oncology, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy
| | - Matteo Brunelli
- Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata (AOUI), University of Verona, Verona, Italy
| | - Rodolfo Montironi
- Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, AOU Ospedali Riuniti, Ancona, Italy
| | - Michelangelo Fiorentino
- Pathology Service, Addarii Institute of Oncology, S-Orsola-Malpighi Hospital, Bologna, Italy
| | - Roberto Iacovelli
- Medical Oncology, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy
| | - Daniel Heng
- Department of Medical Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada
| | - Giampaolo Tortora
- Medical Oncology, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy
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Abstract
Hereditary forms of kidney carcinoma account for 5-8% of all malignant kidney neoplasms. The renal tumors are often multiple and bilateral and occur at an earlier age. Each of the hereditary kidney carcinoma syndromes is associated with specific gene mutations as well as a specific histologic type of kidney carcinoma. The presence of associated extrarenal manifestations may suggest a hereditary kidney cancer syndrome. Radiology is most commonly used to screen and manage patients with hereditary kidney cancer syndromes. This manuscript reviews the clinical and imaging findings of well-defined inherited kidney cancer syndromes including von Hippel-Lindau disease, Birt-Hogg-Dubé syndrome, hereditary papillary renal carcinoma syndrome, hereditary leiomyomatosis and RCC syndrome, tuberous sclerosis complex, and Lynch syndrome.
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98
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Stratton KL, Alanee S, Glogowski EA, Schrader KA, Rau-Murthy R, Klein R, Russo P, Coleman J, Offit K. Outcome of genetic evaluation of patients with kidney cancer referred for suspected hereditary cancer syndromes. Urol Oncol 2016; 34:238.e1-7. [PMID: 26723226 PMCID: PMC4996267 DOI: 10.1016/j.urolonc.2015.11.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/23/2015] [Accepted: 11/23/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To analyze patients with kidney cancer referred for evaluation at a high-volume genetics service at a comprehensive cancer center and identify factors associated with positive tests for hereditary cancer syndromes. METHODS A retrospective review of patients referred to the Clinical Genetics Service at Memorial Sloan-Kettering Cancer Center was performed, and patients with a personal history of kidney cancer were identified. Patient and disease characteristics were reviewed. In all, 4 variables including age at diagnosis of kidney tumor, presence of syndromic manifestations, family history of kidney cancer, and number of primary malignancies were evaluated for association with positive test results in 2 groups: patients tested for renal cell carcinoma syndromes and Lynch syndrome. Guidance for genetic testing strategy in patients with kidney cancer is provided. RESULTS Between 1999 and 2012, 120 patients with a history of kidney cancer were evaluated by the Clinical Genetics Service. The mean age at kidney cancer diagnosis was 52 years (interquartile range: 42-63), with 57% being women. A family history of kidney cancer was reported by 39 patients (33%). Time between diagnosis of first cancer and genetic consultation was <1 year in 54%, 2 to 5 years in 23%, and>5 years in the remaining 23%. Overall, 95 patients were tested for genetic abnormalities with 27 (28%) testing positive. Testing for renal cell carcinoma (RCC)-related syndromes was performed on 43 patients, with 13 testing positive (30%). Lynch syndrome testing was positive in 9 patients (32%) after 28 were tested. In RCC-associated syndromes, young age of diagnosis was associated with positive test results. Conversely, syndromic manifestations and increasing number of primary malignancies were associated with positive Lynch testing. CONCLUSIONS The discovery of inherited kidney cancer syndromes has provided a unique opportunity to identify patients at increased risk for cancer. Factors associated with positive genetic testing are unique to different syndromes. These data suggest that in kidney cancer patients evaluated for hereditary cancer syndromes, young age is associated with diagnosis of RCC syndromes, whereas syndromic manifestations and multiple primaries are found in Lynch syndrome. These results, along with clinical awareness, may be useful for practicing urologists to select patients with kidney cancer to refer for genetic counseling.
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Affiliation(s)
- Kelly L Stratton
- Clinical Genetics Service, Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Surgery, Urology Service, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Shaheen Alanee
- Department of Surgery, Division of Urology, Southern Illinois University, Springfield, Illinois, USA.
| | - Emily A Glogowski
- Clinical Genetics Service, Memorial Sloan-Kettering Cancer Center, New York, NY
| | | | - Rohini Rau-Murthy
- Clinical Genetics Service, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Robert Klein
- Clinical Genetics Service, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Paul Russo
- Clinical Genetics Service, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Jonathan Coleman
- Clinical Genetics Service, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Kenneth Offit
- Clinical Genetics Service, Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Surgery, Urology Service, Memorial Sloan-Kettering Cancer Center, New York, NY
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Rao Q, Xia QY, Cheng L, Zhou XJ. Molecular genetics and immunohistochemistry characterization of uncommon and recently described renal cell carcinomas. Chin J Cancer Res 2016; 28:29-49. [PMID: 27041925 DOI: 10.3978/j.issn.1000-9604.2016.01.03] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Renal cell carcinoma (RCC) compromises multiple types and has been emerging dramatically over the recent several decades. Advances and consensus have been achieved targeting common RCCs, such as clear cell carcinoma, papillary RCC and chromophobe RCC. Nevertheless, little is known on the characteristics of several newly-identified RCCs, including clear cell (tubulo) papillary RCC, Xp11 translocation RCC, t(6;11) RCC, succinate dehydrogenase (SDH)-deficient RCC, acquired cystic disease-associated RCC, hereditary leiomyomatosis RCC syndrome-associated RCC, ALK translocation RCC, thyroid-like follicular RCC, tubulocystic RCC and hybrid oncocytic/chromophobe tumors (HOCT). In current review, we will collect available literature of these newly-described RCCs, analyze their clinical pathologic characteristics, discuss their morphologic and immunohistologic features, and finally summarize their molecular and genetic evidences. We expect this review would be beneficial for the understanding of RCCs, and eventually promote clinical management strategies.
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Affiliation(s)
- Qiu Rao
- 1 Department of Pathology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China ; 2 Department of Pathology and Laboratory, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Qiu-Yuan Xia
- 1 Department of Pathology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China ; 2 Department of Pathology and Laboratory, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Liang Cheng
- 1 Department of Pathology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China ; 2 Department of Pathology and Laboratory, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Xiao-Jun Zhou
- 1 Department of Pathology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China ; 2 Department of Pathology and Laboratory, Indiana University School of Medicine, Indianapolis, IN, USA
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Henegan JC, Gomez CR. Heritable Cancer Syndromes Related to the Hypoxia Pathway. Front Oncol 2016; 6:68. [PMID: 27047799 PMCID: PMC4801850 DOI: 10.3389/fonc.2016.00068] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 03/08/2016] [Indexed: 01/09/2023] Open
Abstract
Families of tumor-suppressor genes, such as those involved in homologous recombination or mismatch repair, contain individual genes implicated in hereditary cancer syndromes. Collectively, such groupings establish that inactivating germline changes in genes within pathways related to genomic repair can promote carcinogenesis. The hypoxia pathway, whose activation is associated with aggressive and resistant sporadic tumors, is another pathway in which tumor-suppressor genes have been identified. von Hippel–Lindau disease, some of the hereditary paraganglioma–pheochromocytoma (PGL/PCC) syndromes, and the syndrome of hereditary leiomyomatosis and renal cell carcinoma are heritable conditions associated with genes involved or associated with the hypoxia pathway. This review links these heritable cancer syndromes to the hypoxia pathway while also comparing the relative aggression and treatment resistance of syndrome-associated tumors to similar, sporadic tumors. The reader will become aware of shared phenotypes (e.g., PGL/PCC, renal cell carcinoma) among these three hypoxia-pathway-associated heritable cancer syndromes as well as the known associations of tumor aggressiveness and treatment resistance within these pathways.
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Affiliation(s)
- John Clark Henegan
- Division of Hematology/Oncology, Department of Medicine, University of Mississippi Medical Center , Jackson, MS , USA
| | - Christian R Gomez
- Cancer Institute, University of Mississippi Medical Center, Jackson, MS, USA; Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, USA; Department of Pathology, University of Mississippi Medical Center, Jackson, MS, USA
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