title: Basic research in kidney cancer.
abstract: BACKGROUND
  Advances in basic research will enhance prognosis, diagnosis, and treatment of renal cancer patients.
  
  
  OBJECTIVE
  To discuss advances in our understanding of the molecular basis of renal cancer, targeted therapies, renal cancer and immunity, and genetic factors and renal cell carcinoma (RCC).
  
  
  METHODS
  Data on recently published (2005-2011) basic science papers were reviewed.
  
  
  RESULTS
  Advances in basic research have shown that renal cancers can be subdivided based on specific genetic profiles. Now that this molecular basis has been established, it is becoming clear that additional events play a major role in the development of renal cancer. For example, aberrant chromatin remodelling appears to be a main driving force behind tumour progression in clear cell RCC. A large number of potential biomarkers have emerged using various high-throughput platforms, but adequate biomarkers for RCC are still lacking. To bring the potential biomarkers and biomarker profiles to the clinical arena is a major challenge for the field. The introduction of tyrosine kinase inhibitors (TKIs) for therapy has shifted the interest away from immunologic approaches. Nevertheless, a wealth of evidence supports immunotherapy for RCC. Interestingly, studies are now appearing that suggest a combination of TKI and immunotherapy may be beneficial. Thus far, little attention has been paid to patient-specific differences. With high-throughput methods becoming cheaper and with the advances in sequencing possibilities, this situation is expected to change rapidly.
  
  
  CONCLUSIONS
  Great strides have been made in the understanding of molecular mechanisms of RCC. This has led this field to the enviable position of having a range of molecularly targeted therapies. Large sequencing efforts are now revealing more and more genes responsible for tumour development and progression, offering new targets for therapy. It is foreseen that through integration of high-throughput platforms, personalised cancer treatment for RCC patients will become possible.
authors: Department of Urology, University Medical Centre Nijmegen, Nijmegen, The Netherlands. e.oosterwijk@uro.umcn.nl
authors: Egbert
authors: E
authors: Oosterwijk
authors: W Kimryn
authors: WK
authors: Rathmell
authors: Kerstin
authors: K
authors: Junker
authors: A Rose
authors: AR
authors: Brannon
authors: Frédéric
authors: F
authors: Pouliot
authors: David S
authors: DS
authors: Finley
authors: Peter F A
authors: PF
authors: Mulders
authors: Ziya
authors: Z
authors: Kirkali
authors: Hirotsugo
authors: H
authors: Uemura
authors: Arie
authors: A
authors: Belldegrun
mesh_terms: D000970:Antineoplastic Agents; D001483:Base Sequence; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000235:genetics* / Q000276:immunology / Q000378:metabolism; D003131:Combined Modality Therapy; D020869:Gene Expression Profiling; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000276:immunology / Q000378:metabolism; D008969:Molecular Sequence Data; D058990:Molecular Targeted Therapy; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors
chemical_list: D000970:Antineoplastic Agents; D011505:Protein-Tyrosine Kinases