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Scientists working on a Cancer Research UK funded study have discovered that the development of kidney cancer follows distinct paths, which can begin in childhood. These evolutionary paths enable scientists to detect whether a tumour will be aggressive and spread.
The study is published in the journal Cell. From the results of this study, scientists have discovered how cancer evolves, and this could lead to the development of clinical tests to give patients a more accurate prognosis and personalised treatment.
In the first two papers, the TRACERx Renal team, based at the Francis Crick Institute, UCL, The Royal Marsden, and Guy’s and St Thomas’, analysed over 1,000 tumour samples from 100 kidney cancer patients to determine the sequence of genetic events that led to the cancer in each patient.
The analysis reveals that there are three evolutionarily distinct types of kidney cancer:
- The first type develops slowly, and does not become aggressive
- The second type forms the most aggressive tumours, which develop as a result of damage to the genes early in the cancer’s development. This enables the tumour to spread to many other parts of the body, often before the primary cancer is diagnosed
- The third tumour type develops through gradual genetic damage, and spreads slowly, often to just one site.
The third paper in this TRACERx Renal study, which was co-led by researchers at the Wellcome Sanger Institute in Cambridge, discovered that the events that trigger kidney cancer development can take place in childhood or adolescence, up to 50 years before the primary tumour is diagnosed. The results present an opportunity for monitoring and early intervention in the treatment of kidney cancer, particularly in high-risk groups, such as those with an inherited risk of developing the disease.
Dr Peter Campbell, corresponding author from the Wellcome Sanger Institute, said: “We can now say what the initiating genetic changes are in kidney cancer, and when they happen. What is remarkable is that the hallmark genomic event that characterises kidney cancer takes place on average 40 to 50 years before the cancer is diagnosed. These first seeds are sown in childhood or adolescence – knowing the sequence of events and their timings opens opportunities for early intervention.”