The Changing Face of Renal Cell Carcinoma: The Impact of Systematic Genetic Sequencing on Our Understanding of This Tumor's Biology

Abstract

Many advances in medicine have followed technological developments rather than intellectual breakthroughs. Although changes in anesthesia and surgical technique might be closest to the patient, it is the field of biology in which these advances have been most dramatic and are likely to have major impacts on patient care in the future. As with other aspects of life, the technological and computational advances in this field have become faster andmore dramatic in recent years. It is in the discovery of gene mutations in cancer that the impact of technology is currently most apparent. Almost 100 yr ago, it was proposed that cancers could arise from mutations of cellular material (reviewed in Cairns [1]). Once the structure ofDNAwasknownand groups of carcinogens identified, it was little time beforemutational assays were developed in yeast to show that these agents were causingmutationswithin theirDNA. As technology and ourunderstatingof tumorepidemiologyadvanced, the roleof genetic events became more apparent, and the hunt for mutations increased. The most promising patients to investigate were those with familial cancer syndromes.