Genomic analyses of renal cell carcinoma employing next generation sequencing

Background: The availability of next generation sequencing (NGS) at economical costs and timely processing has opened up new possibilities to understand the molecular mechanisms of tumor development and treatment.Aims: The development of personalized oncology is based upon these new techniques. Molecular targeted therapies have become standard in many hematologic malignancies, in lung cancer, colorectal cancer, and many more tumor diseases. For renal cell carcinoma (RCC), an ever-growing body of genomic data obtained by NGS exist.Materials and methods: We present a comprehensive literature review and publications from our own patient collective.Results: Several studies in RCC have shown a remarkable heterogeneity not only within the primary tumor but also among different metastases of the same tumor. Heterogeneity further increases under therapy as an expression of molecular evolution. The majority of molecular changes discovered thus far encompass genes that function as tumor suppressors. An exception seems to be rearrangements in the ALK gene.Conclusion: The molecular heterogeneity and the absence of oncogenic driver genes with the exception of ALK rearrangements complicates the development of personalized targeted therapies based on the molecular changes found to date.