TY - JOUR A1 - López, José Ignacio AU - Angulo Cuesta, Javier T1 - Pathological bases and clinical impact of intratumor heterogeneity in clear cell renal cell carcinoma Y1 - 2018 SN - 1527-2737 UR - http://hdl.handle.net/11268/7382 AB - Purpose of review: Intratumor heterogeneity is an inherent event in tumor development that is receiving much attention in the last years since it is responsible for most failures of current targeted therapies. The purpose of this review is to offer clinicians an updated insight of the multiple manifestations of a complex event that impacts significantly patient’s life. Recent findings: Clear cell renal cell carcinoma is the most common renal tumor and a paradigmatic example of a heterogeneous neoplasm. Next-generation sequencing has demonstrated that intratumor heterogeneity encompasses genetic, epigenetic, and microenvironmental variability. Currently accepted protocols of tumor sampling seem insufficient in unveiling intratumor heterogeneity with reliability and need to be updated. This variability challenges the precise morphological diagnosis, its molecular characterization, and the selection of optimal personalized therapies in clear cell renal cell carcinoma, a neoplasm traditionally considered chemo- and radio-resistant. Summary: We review the state of the art of the different approaches to intratumor heterogeneity in clear cell renal cell carcinomas, from the simple morphology to the most sophisticated massive sequencing tools. KW - Células cancerosas KW - Riñones KW - Diagnóstico KW - Cáncer KW - Tratamiento médico KW - Medicina preventiva LA - eng ER -