Epidemiology, biology and treatment of sarcomatoid RCC: current state of the art

Cedric Lebacle1,2, Aydin Pooli3,4, Thomas Bessede5

  • 1Institute of Urologic Oncology (IUO), David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. clebacle@mednet.ucla.edu.

Insights

Sarcomatoid renal cell carcinoma (sRCC) has a poor prognosis due to aggressive biology and late diagnosis. Understanding its molecular origins, like epithelial-mesenchymal transition (EMT), is key to developing new targeted therapies.

Area of Science:

  • Oncology
  • Molecular Pathology

Background:

  • Sarcomatoid dedifferentiation of renal cell carcinoma (sRCC) is a rare but aggressive tumor phenotype associated with a poor prognosis.
  • Patient survival for sRCC rarely exceeds two years due to aggressive biology, advanced stage at diagnosis, and high recurrence rates.

Purpose of the Study:

  • To explore the molecular and genetic underpinnings of sarcomatoid dedifferentiation in renal cell carcinoma.
  • To identify potential actionable targets for improved treatment strategies in sRCC.

Main Methods:

  • Review of molecular pathology studies investigating sarcomatoid dedifferentiation.
  • Analysis of the epithelial-mesenchymal transition (EMT) as a proposed origin of sRCC.

Main Results:

  • Sarcomatoid dedifferentiation is hypothesized to arise from a focal epithelial-mesenchymal transition (EMT) within the carcinomatous component.
  • Current systemic therapies show limited response in sRCC patients.

Conclusions:

  • A deeper understanding of sRCC molecular biology is crucial for developing tailored treatment approaches.
  • Inclusion of sRCC patients in clinical trials for immune, targeted, and combination therapies is essential for advancing treatment strategies.

Related Concept Videos

Introduction to Epidemiology01:26

Introduction to Epidemiology

Epidemiology, known as the cornerstone of public health, involves studying the distribution and determinants of health-related events in defined populations and applying these insights to control health issues. This is essential for understanding how diseases spread, identifying populations at greater risk, and implementing measures to control or prevent outbreaks. Epidemiology addresses not only infectious diseases but also non-communicable conditions like cancer and cardiovascular disease,...
1.9K
Causality in Epidemiology01:21

Causality in Epidemiology

Causality or causation is a fundamental concept in epidemiology, vital for understanding the relationships between various factors and health outcomes. Despite its importance, there's no single, universally accepted definition of causality within the discipline. Drawing from a systematic review, causality in epidemiology encompasses several definitions, including production, necessary and sufficient, sufficient-component, counterfactual, and probabilistic models. Each has its strengths and...
1.7K
Study Designs in Epidemiology01:20

Study Designs in Epidemiology

Epidemiological study designs are fundamental tools for investigating the distribution, determinants, and control of health conditions in populations. They help researchers understand the relationships between exposures and outcomes, and they broadly fall into two categories: "observational" and "experimental" studies.
Observational studies are those where the researcher does not intervene but rather observes natural variations. They include cross-sectional, cohort, and...
1.0K
Confounding in Epidemiological Studies01:27

Confounding in Epidemiological Studies

Confounding in statistical epidemiology represents a pivotal challenge, referring to the distortion in the perceived relationship between an exposure and an outcome due to the presence of a third variable, known as a confounder. This variable is associated with both the exposure and the outcome but is not a direct link in their causal chain. Its presence can lead to erroneous interpretations of the exposure's effect, either exaggerating or underestimating the true association. This...
853
Bias in Epidemiological Studies01:29

Bias in Epidemiological Studies

Biases can arise at various stages of research, from study design and data collection to analysis and interpretation. Recognizing and addressing these biases is essential to ensure the validity and reliability of epidemiological findings.Broadly speaking, biases in epidemiology fall into three main categories: selection bias, information bias, and confounding. A more detailed description of possible biases is:  
1.4K
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
573