’Killer’ kidney cancers identified by studying their evolution

Kidney cancer follows multiple distinct evolutionary paths, finds new research by a team involving UCL. The research will enable the scientists to detect whether a tumour will be aggressive and reveals that the first seeds of kidney cancer are sown as early as childhood. The three Cancer Research UK-funded studies, published in the journal Cell , shed light on the fundamental principles of cancer evolution and could lead to future clinical tests to give patients more accurate prognoses and personalised treatment.  "Understanding how cancers develop and evolve over time is likely to be critical in helping us piece together the information that will point the way to new treatment approaches and predicting outcomes," said Professor Charles Swanton (UCL Cancer Institute, Francis Crick Institute and Cancer Research UK), who was a co-lead author on all three papers. In the first two papers, the TRACERx Renal team*, based at the Francis Crick Institute, UCL, The Royal Marsden NHS Foundation Trust, and Guy's and St Thomas' NHS Foundation Trust, analysed over 1,000 tumour samples from 100 kidney cancer patients in order to reconstruct the sequence of genetic events that led to the cancer in each patient. The analysis reveals that there are three evolutionarily distinct types of kidney cancer. The first type follows a slow evolutionary path, never acquiring the ability to become aggressive. The second type, by contrast, forms the most aggressive tumours, which evolve through a rapid burst of genomic damage - including changes that affect large chunks of the genome - early on in the cancer's development.