Large Genomic Study On Kidney Cancer Brings Hope For More Effective Treatments

Understanding the complexity of cancer is an important goal of the scientific community, and for kidney cancer researchers, this goal just got closer. Dr. Chad Creighton, associate professor of medicine and member of the Dan L Duncan Comprehensive Cancer Center Division of Biostatistics at Baylor College of Medicine, led the study that analyzed nearly 900 kidney cancers at the molecular level. The team discovered that what has historically been considered three significant types of kidney cancer, according to their characteristics under the microscope, could be further distinguished into nine major subtypes through molecular analyses. Each subtype was unique in terms of altered molecular pathways and patient survival. This study made use of data from The Cancer Genome Atlas.

   The researchers hope their findings will pave the way for more effective personalized medicine. Understanding what makes each kidney cancer unique can provide clues to finding targets for effective therapies, and the nine subtypes the research team uncovered find to have therapeutic implications.

“Different types of cancer can show different pathways being dysregulated,” noted senior study author Chad Creighton, Ph.D., associate professor of medicine and member of the Dan L Duncan Comprehensive Cancer Center Division of Biostatistics at Baylor College of Medicine. “And for some of the pathways, we have therapies we can use to target them.”

       The findings from this study were published recently in Cell Reports in an article entitled “Multilevel Genomics-Based Taxonomy of Renal Cell Carcinoma.”

       “We classified 894 renal cell carcinomas (RCCs) of various histologic types into nine major genomic subtypes,” the authors wrote. “Site of origin within the nephron was one major determinant in the classification, reflecting differences among clear cell, chromophobe, and papillary RCC. Widespread molecular changes associated with TFE3 gene fusion or chromatin modifier genes were present within a specific subtype and spanned multiple subtypes.”

         Interestingly, the scientists found that the immune checkpoint pathway was most active in a subtype of clear-cell kidney cancer that is typically very aggressive. The immune checkpoint pathway could be a target for specific therapies.

       “Not all patients have this pathway activated, but the molecular analysis would allow us to identify those patients that represent the best candidates for receiving therapies that target that pathway specifically,” Dr. Creighton explained. “If we have this information, we may know what would work better for the patient. The molecular information can potentially help guide better decisions for treating each patient.”

       The researchers were excited by the results of their extensive analysis and hoped that their data would be used extensively by investigators in the field to continue advancing their studies of kidney cancer.

    “Much is going to be learned about kidney cancer with researchers using these data to answer new questions about the disease,” Dr. Creighton stated.