top of page

BackTable / Urology / Podcast / Episode #81

Germline Testing in Kidney Cancer

with Dr. Ari Hakimi and Dr. Nirmish Singla

In this episode of BackTable Urology, Dr. Aditya Bagrodia, Dr. Ari Hakimi (Memorial Sloan Kettering Cancer Center), and Dr. Nirmish Singla (Johns Hopkins University), discuss the value and indications for germline testing in renal cell carcinoma (RCC).

Be part of the conversation. Put your sponsored messaging on this episode. Learn how.

Germline Testing in Kidney Cancer with Dr. Ari Hakimi and Dr. Nirmish Singla on the BackTable Urology Podcast)
Ep 81 Germline Testing in Kidney Cancer with Dr. Ari Hakimi and Dr. Nirmish Singla
00:00 / 01:04

BackTable, LLC (Producer). (2023, February 16). Ep. 81 – Germline Testing in Kidney Cancer [Audio podcast]. Retrieved from https://www.backtable.com

Free CME

Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs. Follow the button below to claim your credits on CMEfy.

BackTable CMEfy button

Stay Up To Date

Follow:

Subscribe:

Sign Up:

Podcast Contributors

Dr. Ari Hakimi discusses Germline Testing in Kidney Cancer on the BackTable 81 Podcast

Dr. Ari Hakimi

Dr. Ari Hakimi is a urologic surgeon at Memorial Sloan Kettering Cancer Center in New York City.

Dr. Nirmish Singla discusses Germline Testing in Kidney Cancer on the BackTable 81 Podcast

Dr. Nirmish Singla

Dr. Nirmish Singla is the director of translational research in genitourinary oncology at Johns Hopkins University in Baltimore, Maryland.

Dr. Aditya Bagrodia discusses Germline Testing in Kidney Cancer on the BackTable 81 Podcast

Dr. Aditya Bagrodia

Dr. Aditya Bagrodia is an associate professor of urology and genitourinary oncology team leader at UC San Diego Health in California and adjunct professor of urology at UT Southwestern.

Synopsis

First, the doctors explain basic information about germline mutations and kidney cancer. Although historical data has shown that 5% of kidney cancers are inherited, recent efforts to increase testing through commercial testing and large scale efforts at cancer centers have proven that 8-10% of kidney cancers are inherited. Von Hippel Lindau (VHL) syndrome is the most prototypical kidney cancer predisposition syndrome, but there are other less common ones as well. Extrarenal manifestations of VHL syndrome include pancreatic tumors, pancreatic cysts, pheochromocytomas, retinoblastomas, and CNS hemangioblastomas. These tumors have a variable penetrance, but African Americans and women are more likely to have hereditary RCC. The doctors recommend asking newly diagnosed RCC patients about a broad spectrum of their family history that includes cancer and non-malignant conditions, such as uterine leiomyomata. Dr. Hakimi notes that some patients will confuse germline testing with somatic tumor testing, so urologists will have to explain to patients that the VHL mutation was found in their tumor, not in their blood or saliva.

Extended physical exams to look for syndromic conditions can also be performed. A thorough cutaneous exam to look for fibrofolliculomas, leiomyomas, facial angiofibromas, and cafe-au-lait spots can help indicate the presence of a familial syndrome. According to guidelines, all patients diagnosed with RCC under 46 years of age should be recommended to have germline testing. Dr. Bagrodia mentions that having experienced genetic counselors and setting up thorough dot phrases to send to patients explaining their results is helpful for him. Dr. Singla adds that medical geneticists have the ability to counsel the patients more extensively on the risks and benefits of giving consent to go forward with genetic testing. They can also provide psychosocial support and education for the patients.

The doctors then move on to discuss how germline mutations may lead to different treatment modalities. Precision surgery, or utilizing pretest probability information about a tumor to guide surgical approach, may be possible with germline testing. Additionally, testing may help surgeons to decide whether to perform a retroperitoneal lymph node dissection (RPLND). Next, the doctors discuss belzutifan, which is an oral drug used to treat VHL familial syndrome tumors. Finally, they discuss the use of tumor sequencing for research purposes and share what they are most excited for in the field of RCC research.

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

backtable-earn-free-cme.jpg
backtable-plus-vi-cta.jpg
Become a BackTable Sponsor

Up Next

Solving Semen Analysis Barriers: Innovation & Accessibility with Dr. James Smith on the BackTable Urology Podcast)
Innovating Urology: Surgeons Trailblazing Solutions with Dr. Alexandra Haessler, Dr. Jay Shakuri-Rad, and Dr. Tova Weiss on the BackTable Urology Podcast)
Empowering Clinicians through Quality Improvement Initiatives with Dr. Andrew Harris on the BackTable Urology Podcast)
Urology Advocacy: From Passion to Policy with Dr. Seth Cohen and Dr. Michelle Leach on the BackTable Urology Podcast)
Navigating Physician Partnerships: Understanding Stark Law with Clint Davis and David Soler on the BackTable Urology Podcast)
Perfecting Rectal Spacer Placement for Optimal Care with Dr. Neil Taunk on the BackTable Urology Podcast)

Articles

Topics

Kidney Cancer Condition Overview
Learn about Urologic Oncology on BackTable Urology

Get in touch!

We want to hear from you. Let us know if you’re interested in partnering with BackTable as a Podcast guest, a sponsor, or as a member of the BackTable Team.

Select which show(s) you would like to subscribe to:

Thanks! Message sent.

bottom of page