China
Africa
Explore chapters and articles related to this topic
Urological Anti-cancer Agents
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Bernadett Szabados, Thomas Powles
Loss of function of the von Hippel-Lindau (VHL) gene → VHL diseaseChromosome 3p.Most common cause for inherited clear cell renal cell carcinoma (RCC).
Renal Cancer
Published in Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed, MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Nilay Patel (deceased), Vinodh Murali, David Cranston
Clear cell renal cell carcinoma accounts for 80%–90% of renal cancers. Loss of function of the VHL gene had been demonstrated in up to 95% of cases. These tumours are usually solitary but appear multifocally in 4% of cases and bilaterally in 3%. Microscopically CCRCC appear as clear cytoplasm cells due to their high content of glycogen and lipids. The growth pattern may be solid, tubular or cystic. CD10 expression has been observed in 94% of cases and CA9 in 90% of clear cell tumours.
Birt–Hogg–Dubé Syndrome
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
Marianne Geilswijk, Mette Sommerlund, Mia Gebauer Madsen, Anne-Bine Skytte, Elisabeth Bendstrup
In sporadic renal tumors, aggressive clear cell renal cell carcinoma (ccRCC) is the most common subtype (75%), followed by papillary RCC (pRCC, 10%), low-aggressive chromophobe RCC (chRCC, 5%), benign oncycotoma (5%), and other rare subtypes (<5%) [56]. This is in contrast to the BHD-associated renal tumors, where the majority are oncocytoma, chRCC, or hybrid chromophobe-oncocytoma type. Pavlovich et al. were the first to present a systematic pathologic analysis of BHD-associated renal tumors. They reviewed 130 renal tumors resected from 30 BHD patients, including 65 hybrid chromophobe-oncocytoma type (50%), 44 chRCC (34%), 12 ccRCC (9%), 7 oncocytoma (5%), and 2 pRCC (2%) [56]. In a cohort of French BHD patients, Benusiglio et al. reported a total of 124 patients in which 33 renal tumor (27%), 23 oncocytoma or hybrid chromophobe-oncocytoma type (70%), 3 ccRCC (9%), and 1 pRCC (3%) were identified histopathologically, while the remaining patients had no histopathological data [57]. This pattern is remarkably different from the histologic spectrum in sporadic renal tumors confirmed by several studies [35,42,58]. It is recommended by The International Society of Urological Pathology Tumor Panel that a diagnosis of BHD should be considered when a hybrid chromophobe-oncocytoma tumor is found [59]. Oncocytosis is observed histologically in about half of the BHD-associated tumors [60]. Renal oncocytosis is characterized by a spectrum of oncocytic changes that diffusely involve the renal parenchyma, and it is possibly a precancerous lesion [54,60,61].
Identification of inhibitors targeting HIF-2α/c-Myc by molecular docking and MM-GBSA technology
Published in Journal of Receptors and Signal Transduction, 2021
Lijun Feng, Chuance Sun, Xiaohua Sun, Yang Zhao, Rilei Yu, Congmin Kang
Clear cell renal cell carcinoma (ccRCC) is one of the most dangerous adult malignances in the world, and the cause of ccRCC has become the research focus, recently. Most ccRCCs are associated with inactivation of the von Hippel-Lindau tumor suppressor gene (VHL), and it is also related to the expression of HIF-2α [1]. Hypoxia-inducible factor (HIF) is expressed in organisms and is a basic helix-loop-helix (bHLH) Per-ARNT-Sim (PAS) domain transcription factor. HIF includes HIFα (related protein HIF-1α, HIF-2α, and HIF-3α) and HIFβ (aryl hydrocarbon receptor nuclear translocator) subunits. HIFα and HIFβ formed heterodimers. Heterodimer complexes are involved in transcription and regulate the expression of genes related to hypoxia mechanisms [2]. In the case of sufficient oxygen in the cell, HIFα can be degrades by protease after a series of reactions [3]. However, under the conditions of hypoxia and VHL protein inactivation [4], HIF-α subunits quickly accumulated and entered the nucleus forming a dimer with HIF-1β. This dimer regulates the expression of multiple gene and is a key transcriptional regulator of neoangiogenesis [5–7]. The transcriptional activity of HIF-2α enhances the tumor’s adaptability, growth ability, and metastatic potential [8]. Interestingly, HIF-1α and HIF-2α behave in opposite ways in VHL-deficient RCCs: Overexpression of HIF-2α promotes an increase in the mass of RCC tumors, while increased expression of HIF-1α suppresses the tumor’s growth [9].
Combination of immune checkpoint inhibitors and tyrosine kinase inhibitors for the treatment of renal cell carcinoma
Published in Expert Opinion on Biological Therapy, 2021
Viktoria Stühler, Steffen Rausch, Jan Moritz Maas, Arnulf Stenzl, Jens Bedke
As an example of treatment de-escalation, the phase 2 KEYNOTE-427 study (NCT02853344) evaluated pembrolizumab monotherapy in previously untreated patients with both clear cell and non-clear cell advanced RCC and demonstrated a significantly more favorable toxicity profile than combination therapies as well as remarkable response rates. Updated results with a median follow-up of >2 years were presented at ASCO GU 2020 for ccRCC and showed an ORR in IMDC favorable and intermediate/poor risk of 31.0% and 39.7%, respectively; the 18-months OS rate was 95.2% for favorable and 70.5% for intermediate/poor IMDC risk, and 38% of responders had maintained response for >6 months after treatment discontinuation [75]. For non-clear cell renal cell carcinoma, the ORR at more than 2 years of follow-up was 26.1% with a PFS rate of 18.9% and an OS rate of 67.0% at 18 months of follow-up, with 43% of responders having a sustained response [76]. The general advantages and disadvantages of the therapy regimens with ICI or TKI are summarized in Table 4.
Does renal mass biopsy influence multidisciplinary treatment recommendations?
Published in Scandinavian Journal of Urology, 2020
Jennifer M. Lobo, Matthew B. Clements, Daniel P. Bitner, Matthew D. Mikula, Sean W. Noona, Mark I. Sultan, Helen P. Cathro, Drew L. Lambert, Noah S. Schenkman, Tracey L. Krupski
We prospectively added consecutive patients identified with SRMs to the database. Thirty-nine variables related to patient demographics, co-morbidities, tumor pathology, laboratory, radiographic features and recommendations were collected into a MySQL database (Supplementary Table 1). GFR was estimated using the Cockcroft–Gault formula [19]. If the following terms were employed by the pathologist, we considered the tumor benign: oncocytic cells, oncocytoma, oncocytic neoplasm or angiomyolipoma. Terms diagnostic of carcinoma included renal cell carcinoma, clear cell carcinoma (ccRCC) or papillary carcinoma. Terms such as suspicious, inflammation/fibrosis or atypia were considered non-diagnostic. While normal kidney tissue could also be non-diagnostic, we did not have any such cases.