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Pathological Bases and Clinical Impact of Intratumor Heterogeneity in Clear Cell Renal Cell Carcinoma

  • Kidney Diseases (G Ciancio, Section Editor)
  • Published:
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Abstract

Purpose of Review

Intratumor heterogeneity is an inherent event in tumor development that is receiving much attention in the last years since it is responsible for most failures of current targeted therapies. The purpose of this review is to offer clinicians an updated insight of the multiple manifestations of a complex event that impacts significantly patient’s life.

Recent Findings

Clear cell renal cell carcinoma is the most common renal tumor and a paradigmatic example of a heterogeneous neoplasm. Next-generation sequencing has demonstrated that intratumor heterogeneity encompasses genetic, epigenetic, and microenvironmental variability. Currently accepted protocols of tumor sampling seem insufficient in unveiling intratumor heterogeneity with reliability and need to be updated. This variability challenges the precise morphological diagnosis, its molecular characterization, and the selection of optimal personalized therapies in clear cell renal cell carcinoma, a neoplasm traditionally considered chemo- and radio-resistant.

Summary

We review the state of the art of the different approaches to intratumor heterogeneity in clear cell renal cell carcinomas, from the simple morphology to the most sophisticated massive sequencing tools.

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Funding

This work has been partially funded by grant SAF-2016-79847-R from Ministerio de Economía y Competitividad (MINECO), Spain.

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Authors and Affiliations

  1. Department of Pathology, Cruces University Hospital, Biocruces Research Institute, University of the Basque Country (UPV/EHU), 48903, Barakaldo, Spain

    José I. López

  2. Clinical Department, Urology, Hospital Universitario de Getafe, Universidad Europea de Madrid, 28905, Madrid, Spain

    Javier C. Angulo

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  1. José I. López
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  2. Javier C. Angulo
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Correspondence to José I. López.

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José I. López and Javier C. Angulo each declares no potential conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Kidney Diseases

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López, J.I., Angulo, J.C. Pathological Bases and Clinical Impact of Intratumor Heterogeneity in Clear Cell Renal Cell Carcinoma. Curr Urol Rep 19, 3 (2018). https://doi.org/10.1007/s11934-018-0754-7

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