The genetic basis of kidney cancer

Published on September 3, 2014   52 min

Other Talks in the Series: The Kidney in Health and Disease

Other Talks in the Series: Molecular Genetics of Human Disease

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I'm Marston Linehan, I'm the chief of the Urologic Oncology branch at the National Cancer Institute, at the National Institutes of Health. And we're going to talk about the genetic basis of kidney cancer.
Kidney cancer affects nearly 300,000 patients worldwide each year, and is responsible for nearly 120,000 deaths worldwide, annually. It's predicted that there are 200,000 patients alive with kidney cancer in the United States.
I'm a urologic surgeon, and if a patient came to someone like me with localized kidney cancer, we remove their tumor. We could cure to 95% of those patients.
However, if a patient comes to someone like me, or to a physician, with advanced disease, they have only a 19% or 20%, two-year survival. So it's been nearly 30 years ago now that we started working on kidney cancer, and our goal was to identify the gene-- we thought it was a gene at the time, we didn't realize it was genes-- to identify the gene that causes kidney cancer. And our hope was that we could then study that gene pathway to develop an approach for therapy for patients with advanced forms of kidney cancer.
So I'm going to talk with you about our process over the past 30 years or so, and our experience and what we've learned about kidney cancer in that time. So when we started, kidney cancer was thought to be a single disease. We treated all patients the same surgically, did the same operation for each. We gave patients with metastatic or advanced disease the same drugs, none of which worked. We now know that kidney cancer is not a single disease. It's a number of different types of cancer that happen to occur in the kidney. They have different histologies, as you can see on this slide. The patients undergo different clinical courses. They respond differently to therapy. And as I'll show you, they're caused by different genes.