JAMA Clinical Reviews cover image

JAMA Clinical Reviews

Renal Cell Carcinoma

Aug 28, 2024
William Y. Kim, MD, a renowned expert from the University of North Carolina, joins JAMA Associate Editor David L. Simel, MD, MHS, to dive deep into renal cell carcinoma. They discuss groundbreaking links to Nobel-winning research on tumor suppressors and hypoxia-inducible factors. The conversation covers diagnostic challenges, genetic screening, and the importance of evaluating familial history. Treatment options are also highlighted, emphasizing advancements in surgical techniques and personalized therapies for advanced stages of the disease.
21:14

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Quick takeaways

  • Renal cell carcinoma features a significant prevalence with a high survival rate if detected early, reaching over 94% cancer-specific survival.
  • Advancements in targeted therapies and immunotherapy have revolutionized the treatment landscape for advanced renal cell carcinoma, significantly improving patient outcomes.

Deep dives

Understanding Renal Cell Carcinoma's Molecular Basis

Research has revealed significant insights into the molecular mechanisms underlying renal cell carcinoma, particularly the role of the von Hippel-Lindau (VHL) tumor suppressor gene and hypoxia-inducible factor (HIF) proteins. The discovery that mutations in the VHL gene, commonly found in clear cell kidney cancer, affect the degradation of HIF alpha proteins leads to increased levels of vascular endothelial growth factor (VEGF). These changes promote tumor growth and vascularization, highlighting the importance of understanding oxygen sensing in developing targeted therapies. Consequently, this newfound knowledge has driven advancements in treatment strategies for kidney cancer, illustrating the impact of basic science on clinical practice.

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