title: Potential role of genetic markers in the management of kidney cancer.
abstract: BACKGROUND
  Kidney cancer is not a single entity but comprises a number of different types of cancer that occur in the kidney including renal cell tumours as the most common type. Four major renal cell tumour subtypes can be distinguished based on morphologic and genetic characteristics. To individualise therapy and to improve the prognosis in patients with renal cell tumours, accurate subtyping, definition of individual course of disease, and the prediction of therapy response are necessary.
  
  
  OBJECTIVE
  To discuss the potential role of genetic markers in the management of kidney cancer.
  
  
  METHODS
  A Medline search was conducted to identify original articles, review articles, and editorials addressing the role of genetic alterations in kidney cancer management. Keywords included kidney neoplasms, genetics, SNP, gene expression, miRNA, classification, diagnosis, drug therapy, prognosis, and therapy. The articles with the highest level of evidence were identified and critically reviewed. This review is the result of an interactive peer-reviewing process by an expert panel of co-authors.
  
  
  RESULTS
  Each subtype is characterised by specific genetic, epigenetic, and expression patterns that potentially can be used to subclassify renal cell tumours in cases of ambivalent histopathology. Molecular signatures and single alterations in primary tumours are associated with aggressiveness and prognosis. Germline polymorphisms in specific genes encoding for metabolizing enzymes, efflux transporters, and drug targets seem to be associated with toxicity and response in patients receiving targeted therapy.
  
  
  CONCLUSIONS
  Significant advances have been achieved in the molecular analysis of renal cancer. Validation of findings is greatly needed to implement genetic markers in the management of renal cancer. This should lead to improved diagnosis, prognosis, and personalised therapy in this heterogeneous disease.
authors.affiliation: Clinic of Urology and Pediatric Urology, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg, Germany. kerstin.junker@uks.eu
authors.forename: Kerstin
authors.initials: K
authors.lastname: Junker
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ficarra
authors.forename: Eugene D
authors.initials: ED
authors.lastname: Kwon
authors.forename: Bradley C
authors.initials: BC
authors.lastname: Leibovich
authors.forename: R Houston
authors.initials: RH
authors.lastname: Thompson
authors.forename: Egbert
authors.initials: E
authors.lastname: Oosterwijk
mesh_terms: D018249:Adenoma, Oxyphilic / Q000235:genetics / Q000628:therapy; D002292:Carcinoma, Renal Cell / Q000235:genetics* / Q000628:therapy; D044127:Epigenesis, Genetic; D020869:Gene Expression Profiling; D015972:Gene Expression Regulation, Neoplastic; D005819:Genetic Markers; D006801:Humans; D007680:Kidney Neoplasms / Q000235:genetics* / Q000628:therapy; D058990:Molecular Targeted Therapy; D020641:Polymorphism, Single Nucleotide; D011379:Prognosis
chemical_list: D005819:Genetic Markers