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      The Cancer Genome Atlas of renal cell carcinoma: findings and clinical implications

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      Nature Reviews Urology
      Springer Science and Business Media LLC

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          On the origin of cancer cells.

          O WARBURG (1956)
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            Multiplatform analysis of 12 cancer types reveals molecular classification within and across tissues of origin.

            Recent genomic analyses of pathologically defined tumor types identify "within-a-tissue" disease subtypes. However, the extent to which genomic signatures are shared across tissues is still unclear. We performed an integrative analysis using five genome-wide platforms and one proteomic platform on 3,527 specimens from 12 cancer types, revealing a unified classification into 11 major subtypes. Five subtypes were nearly identical to their tissue-of-origin counterparts, but several distinct cancer types were found to converge into common subtypes. Lung squamous, head and neck, and a subset of bladder cancers coalesced into one subtype typified by TP53 alterations, TP63 amplifications, and high expression of immune and proliferation pathway genes. Of note, bladder cancers split into three pan-cancer subtypes. The multiplatform classification, while correlated with tissue-of-origin, provides independent information for predicting clinical outcomes. All data sets are available for data-mining from a unified resource to support further biological discoveries and insights into novel therapeutic strategies. Copyright © 2014 Elsevier Inc. All rights reserved.
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              Is Open Access

              Tracking Cancer Evolution Reveals Constrained Routes to Metastases: TRACERx Renal

              Summary Clear-cell renal cell carcinoma (ccRCC) exhibits a broad range of metastatic phenotypes that have not been systematically studied to date. Here, we analyzed 575 primary and 335 metastatic biopsies across 100 patients with metastatic ccRCC, including two cases sampledat post-mortem. Metastatic competence was afforded by chromosome complexity, and we identify 9p loss as a highly selected event driving metastasis and ccRCC-related mortality (p = 0.0014). Distinct patterns of metastatic dissemination were observed, including rapid progression to multiple tissue sites seeded by primary tumors of monoclonal structure. By contrast, we observed attenuated progression in cases characterized by high primary tumor heterogeneity, with metastatic competence acquired gradually and initial progression to solitary metastasis. Finally, we observed early divergence of primitive ancestral clones and protracted latency of up to two decades as a feature of pancreatic metastases.
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                Author and article information

                Journal
                Nature Reviews Urology
                Nat Rev Urol
                Springer Science and Business Media LLC
                1759-4812
                1759-4820
                July 5 2019
                Article
                10.1038/s41585-019-0211-5
                31278395
                184073b5-fac1-4eab-9437-54a5dd10c08a
                © 2019

                http://www.springer.com/tdm

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