Resumen:
Intratumor heterogeneity (ITH) is a constant evolutionary event in all malignant tumors,
and clear cell renal cell carcinoma (CCRCC) is a paradigmatic example. ITH is responsible for most
therapeutic failures in the era of precision oncology, so its precise detection remains a must in modern
medicine. Unfortunately, classic sampling protocols do not resolve the problem as expected and
several strategies have been being implemented in recent years to improve such detection. Basically,
multisite tumor sampling (MSTS) and the homogenization of the residual tumor tissue are on display.
A next step of the MSTS strategy considering the recently discovered patterns of ITH regionalization
is presented here, the so-called personalized MSTS (pMSTS). This modification consists of paying
more attention to sample the tumor periphery since it is this area with maximum levels of ITH.