KCJ ORIGINAL CONTRIBUTION What morphology can teach us about renal cell carcinoma clonal evolution Payal Kapur, MD, Alana Christie, MS, Satwik Rajaram, PhD, and James Brugarolas, MD, PhD AbstractWhile cancer is a clonal process, cumulative evidence suggest that tumors are rather heterogenous and are composed of multiple genetically-distinct subclones that arise at different times and either persist and co-exist, expand and evolve, or are eliminated. A paradigm of tumor heterogeneity is renal cell carcinoma (RCC). By exploiting morphological traits and building upon a framework around three axes (architecture, cytology and the microenvironment), we review recent advances in our understanding of RCC evolution leading to an integrated molecular genetic and morphologic evolutionary model with both prognostic and therapeutic implications. The ability to predict cancer evolution may have profound implications for clinical care and is central to oncology. …. Show full content
KCJ BRIEF COMMUNICATION Mechanistic Insights into the Obesity Paradox and Implications for Therapy Ritesh R. Kotecha, MD AbstractExciting progress has been made towards uncovering mechanisms which underlie the paradoxical impact of obesity in renal cell carcinoma, suggesting new treatment strategies in this patient population. Enhancing our understanding of the complex interactions within the tumor microenvironment may allow us to identify novel targets for therapeutic action ...Show full content
KCJ LETTER TO THE EDITOR Harnessing Big Data with Machine Learning in Precision Oncology Nirmish Singla, MD, MSCS, Shyamli Singla, MD AbstractWhile multi-level molecular “omic” analyses have undoubtedly increased the sophistication and depth with which we can understand cancer biology, the challenge is to make this overwhelming wealth of data relevant to the clinician and the individual patient. Bridging this gap serves as the cornerstone of precision medicine, yet the expense and difficulty of executing and interpreting these molecular studies make it impractical to routinely implement them in the clinical setting. Herein, we propose that machine learning may hold the key to guiding the future of precision oncology accurately and efficiently. Training deep learning models to interpret the histopathologic or radiographic appearance of tumors and their microenvironment—a phenotypic microcosm of their inherent molecular biology—has the potential to output relevant diagnostic, prognostic, and therapeutic patient-level data. This type of artificial intelligence framework may effectively shape the future of precision oncology by fostering multidisciplinary collaboration ...Show full content
KCJ COMMENTARY Assessment of Intratumoral Histologic Heterogeneity in Clear Cell Renal Cell Carcinoma: Opportunities to Inform Molecular Studies and Therapeutic Approach? Steven Christopher Smith, MD, PhD1 and Mahul B. Amin, MD2 AbstractThe past four and a half decades have witnessed amazing progress in the management of renal cell carcinoma (RCC), in large part due to developments in histologic classification. As recently as 19751, the histologic diversity of RCC encompassed only two types – clear cell and granular cell RCC. Careful histologic observations over the next two decades, validated by cytogenetic correlations2 led to greater understanding of RCC as being composed of numerous subtypes each with unique clinical, morphologic, and prognostic implications3. Continuing interest in histopathology and growing use of molecular analyses have taken classification of RCC to a greater level of diagnostic complexity, in turn facilitating improved clinical efficacy ...Show full content
KCJ EDITOR’S MEM0 Robert A. Figlin MD For the first time in its 56-year history, the ASCO Annual Scientific Meeting was held entirely virtually due to the global outbreak of the COVID-19 that swept the world. Despite the odds, the 3-day scientific program was broadcasted to a record-breaking audience of more than 42,700 attendees from 130 countries. Moreover, the content of the conference has been viewed more than 2.5 million times as of June 4, 2020. During the conference sessions, attendees were able to view 5300 abstracts and more than a hundred on-demand and broadcast sessions and over 2300 poster and oral presentations throughout the weekend ...Show full content
KCJ MEDICAL INTELLIGENCE Newsworthy, late-breaking information from Web-based sources, professional societies, and government agencies ...Show full content
KCJ JOURNAL CLUB Essential Peer-Reviewed Reading in Kidney Cancer The peer-reviewed articles summarized in this section were selected by the Editor-in-Chief, Robert A. Figlin, MD, for their timeliness, importance, relevance, and potential impact on clinical practice or translational research ...Show full content
ISSN 1933-0863 (PRINT) ISSN 1933-0871 (ONLINE)
ISSN 1933-0863 (PRINT) ISSN 1933-0871 (ONLINE)
