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Genetic Alterations in Renal Cancers: Identification of The Mechanisms Underlying Cancer Initiation and Progression and of Therapeutic Targets

Department of Oncology, Istituto Superiore di Sanità, Vaile Regina Elena 299, 00161 Rome, Italy
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Received: 22 June 2020 / Revised: 19 July 2020 / Accepted: 24 July 2020 / Published: 29 July 2020
Renal cell cancer (RCC) involves three most recurrent sporadic types: clear-cell RCC (70–75%, CCRCC), papillary RCCC (10–15%, PRCC), and chromophobe RCC (5%, CHRCC). Hereditary cases account for about 5% of all cases of RCC and are caused by germline pathogenic variants. Herein, we review how a better understanding of the molecular biology of RCCs has driven the inception of new diagnostic and therapeutic approaches. Genomic research has identified relevant genetic alterations associated with each RCC subtype. Molecular studies have clearly shown that CCRCC is universally initiated by Von Hippel Lindau (VHL) gene dysregulation, followed by different types of additional genetic events involving epigenetic regulatory genes, dictating disease progression, aggressiveness, and differential response to treatments. The understanding of the molecular mechanisms that underlie the development and progression of RCC has considerably expanded treatment options; genomic data might guide treatment options by enabling patients to be matched with therapeutics that specifically target the genetic alterations present in their tumors. These new targeted treatments have led to a moderate improvement of the survival of metastatic RCC patients. Ongoing studies based on the combination of immunotherapeutic agents (immune check inhibitors) with VEGF inhibitors are expected to further improve the survival of these patients. View Full-Text
Keywords: renal cell cancer; genomic landscape; targeted therapy; tumor evolution; tumor heterogeneity renal cell cancer; genomic landscape; targeted therapy; tumor evolution; tumor heterogeneity
MDPI and ACS Style

Testa, U.; Pelosi, E.; Castelli, G. Genetic Alterations in Renal Cancers: Identification of The Mechanisms Underlying Cancer Initiation and Progression and of Therapeutic Targets. Medicines 2020, 7, 44. https://0-doi-org.brum.beds.ac.uk/10.3390/medicines7080044

AMA Style

Testa U, Pelosi E, Castelli G. Genetic Alterations in Renal Cancers: Identification of The Mechanisms Underlying Cancer Initiation and Progression and of Therapeutic Targets. Medicines. 2020; 7(8):44. https://0-doi-org.brum.beds.ac.uk/10.3390/medicines7080044

Chicago/Turabian Style

Testa, Ugo, Elvira Pelosi, and Germana Castelli. 2020. "Genetic Alterations in Renal Cancers: Identification of The Mechanisms Underlying Cancer Initiation and Progression and of Therapeutic Targets" Medicines 7, no. 8: 44. https://0-doi-org.brum.beds.ac.uk/10.3390/medicines7080044

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