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Hereditary Renal Cell Carcinoma

Hereditary Leiomyomatosis and Renal Cell Cancer

Patients with known or suspected heritable kidney cancer syndromes, including VHL and HLRCC Disease.

Family members (related by blood) of patients who have or are suspected of having heritable kidney cancer syndromes, including VHL and HLRCC Disease.

Patients and biologic family members with a heritable kidney cancer syndrome of suspected, but not proven genetic etiology.

Next generation sequencing of blood, urine and/or benign and malignant tissue of patients and family members with known or suspected heritable kidney cancer syndromes, including VHL and HLRCC Disease.

Gene test

Yunze Xu, Ph.D.

Qi Lu

Jin Zhang

This study will investigate the frequency, clinical phenotype, management and molecular genetic defects of heritable kidney cancer syndromes. Families with kidney cancer with known or suspected genetic basis will be enrolled. Affected individuals or individuals suspected of having a germline kidney cancer will undergo periodic clinical assessment and genetic analyses for the purpose of: 1) definition and characterization of phenotype, 2) determination of the natural history of the disorder, and 3) genotype/phenotype correlation. Genetic linkage studies may be performed in situations in which the genetic basis of the disorder has not been elucidated. This research will have a significant impact on the overall management of heritable kidney cancer syndromes patients and family members who are at risk for heritable kidney cancer syndromes. The study will ultimately facilitate the development of novel screening, prevention and treatment strategies for these individuals with the syndrome. In addition this study could have impact on the management of patients with personal and/or family history of heritable kidney cancer syndromes.

Background:

• The genetic etiology of heritable kidney cancer syndromes remains to be determined.

Objectives:

* Define the risk of developing renal cance in heritable kidney cancer syndromes
* Define the types and characteristics (including patterns of growth) of heritable kidney cancer syndromes.
* Determine genotype/phenotype correlations.
* To characterize the natural and clinical histories of heritable kidney cancer syndromes.
* To determine the genetic etiology of heritable kidney cancer syndromes.

Design:

* These rare families will be recruited to genetically confirm diagnosis, determine size and location of renal tumors, size at presentation, growth rate and metastatic potential of renal tumors.
* Genetic testing will be offered to gain appreciation of the effect of mutations on the relative activity of various germline and somatic mutations.
* To determine if there is a relationship between mutation and disease manifestations and phenotype.

Frequency, Clinical Phenotype and Genetic Analysis of Heritable Kidney Cancer Syndromes

Genotyping for genetic variants that could modify the risk of cancer in subjects.

Questionnaire and chart review of the clinical phenotype

Frequency of germline pathogenic/likely pathogenic variants in renal cancer

Ruijin Hospital

Shanghai Zhongshan Hospital

Huashan Hospital

Xinhua Hospital, Shanghai Jiao Tong University School of Medicine

Zhejiang Provincial People's Hospital

Tongji Hospital

Second Affiliated Hospital, School of Medicine, Zhejiang University

Shanghai 10th People's Hospital

First Affiliated Hospital, Sun Yat-Sen University

Peking University First Hospital

RenJi Hospital

Leiomyomatosis

Disease Attributes

Patients with known or suspected Hereditary Leiomyomatosis and Renal Cell Cancer Syndrome (HLRCC)

Family members (related by blood) of patients who have or are suspected of having Hereditary Leiomyomatosis and Renal Cell Cancer Syndrome (HLRCC)

Spouses enrolled primarily for linkage analysis (Spouses have been removed from the inclusion criteria for this study. This closed cohort is for spouses previously enrolled on study.)

Deborah A Nielsen, R.N.

W. Marston Linehan, M.D.

For more information at the NIH Clinical Center contact National Cancer Institute Referral Office

This study will investigate what causes hereditary leiomyomatosis renal (kidney) cell cancer, or HLRCC, and how the disease is related to the development of kidney tumors. Leiomyomas are benign (non-cancerous) tumors arising from smooth muscle. HLRCC can cause various health problems. Some people develop red bumps on their skin that can be painful at times. Some women with HLRCC can develop leiomyomas of the uterus. In some families, people with HLRCC develop kidney tumors. This study will try to determine:

* What gene changes (mutations) cause HLRCC
* What kind of kidney tumors develop in HLRCC and how they grow
* What the chance is that a person with HLRCC will develop a kidney tumor

People with known or suspected HLRCC (and their family members of any age) may be eligible for this study. This includes people in families in which one or more members has skin leiomyoma and kidney cancer; skin leiomyoma and uterine leiomyoma; multiple skin leiomyomas; kidney cancer and uterine leiomyomas, or kidney cancer consistent with HLRCC, including, but not limited to, collecting duct or papillary, type II. Candidates will be screened with a physical examination, family history, and, for affected family members, a review of medical records, including pathology slides and computed tomography (CT) or magnetic resonance imaging (MRI) scans.

Participants will undergo tests and procedures that may include the following:

* Review of medical records, x-rays, and tissue slides
* Physical examination and family history
* Skin examination
* Gynecological examination for women
* Interviews with a cancer doctor, cancer nurses, kidney surgeon, and genetic counselor
* Blood tests for:

  1. Genetic research to identify the gene responsible for HLRCC
  2. Evaluation of liver, kidney, heart, pancreas, and thyroid function
  3. Complete blood count and clotting profile
  4. Pregnancy test for pre-menopausal women
  5. PSA test for prostate cancer in men over age 40
* CT or MRI scans (for participants 15 years of age and older only)
* Skin biopsy (surgical removal of a small sample of skin tissue)
* Cheek swab or mouth rinse to collect cells for genetic analysis
* Medical photographs of lesions
* Questionnaire

When the tests are completed, participants will discuss the results with a doctor and possibly a genetic nurse or genetic counselor. The genetic findings will not be revealed to participants because their meaning and implications may not yet be understood. Participants may be asked to return to NIH from every 3 months to every 3 years, depending on their condition, for follow-up examinations and tests.

Background:

* Hereditary Leiomyomatosis and Renal Cell Cancer (HLRCC) is a rare autosomal dominantly inherited disorder which confers susceptibility to develop cutaneous and uterine leiomyomas and renal cell carcinoma.
* HLRCC is caused by mutations in the Krebs cycle enzyme, fumarate hydratase localized on chromosome 1q42.3-q43.

Objectives:

* Define the risk of developing renal cancer, cutaneous leiomyoma and uterine leiomyoma in this hereditary cancer syndrome
* Define the types and characteristics (including patterns of growth) of renal cancer associated with HLRCC.
* Determine the incidence and characteristics of HLRCC-associated fumarate hydratase gene mutations.
* Determine genotype/phenotype correlations.
* Determine if other genes caused HLRCC.

Eligibility:

-An individual from a family in which one or more biological family members have:

* Cutaneous leiomyoma and kidney cancer.
* Cutaneous leiomyoma and uterine leiomyoma.
* Multiple cutaneous leiomyoma.
* Kidney cancer and uterine leiomyomata.
* Renal tumor histology consistent with HLRCC including, but not limited to: Collecting Duct and/or Papillary, Type II.

Design:

* These rare biological families will be recruited to genetically confirm diagnosis, determine size and location of renal tumors, size at presentation, growth rate and metastatic potential of renal tumors.
* Genetic testing will be offered to gain appreciation of the effect of mutations on the relative activity of various germline and somatic mutations.
* We will determine if there is a relationship between mutation and disease phenotype.

Hereditary Leiomyomatosis Renal Cell Cancer - Study of the Genetic Cause and the Predisposition to Renal Cancer

Hereditary Leiomyomatosis Renal Cell Cancer (HLRCC): Identification of the Disease Gene, and Characterization of the Predisposition to Renal Cancer

.All IPD recorded in the medical record will be shared with intramural investigators upon request. @@@@@@In addition, all large scale genomic sequencing data will be shared with subscribers to dbGaP.

Molecular genetic differences between normal and tumorigenic fumarate hydratase (fumerase) mutations.

Collection of blood, urine and/or benign and malignant tissue.

Molecular genetic differences between normal and tumorigenic cells.

Detection and expression analysis of gene(s).

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Frequency, Clinical Phenotype and Genetic Analysis of Heritable Kidney Cancer Syndromes	NCT05534854	Renal Tumor His... Kidney Cancer Renal Cell Carc... Familial Renal ... HLRCC VHL Syndrome BAP1 Tumor Pred... FLCN Gene Mutat... ALK Gene Mutati... FH Gene Mutatio... Birt-Hogg-Dube ... MET Gene Mutati... Cutaneous Leiom... Cutaneous Leiom...	Gene test	2 Years -	RenJi Hospital
Hereditary Leiomyomatosis Renal Cell Cancer - Study of the Genetic Cause and the Predisposition to Renal Cancer	NCT00050752	Renal Tumor His... Cutaneous Leiom... Kidney Cancer		2 Years -	National Institutes of Health Clinical Center (CC)
Frequency, Clinical Phenotype and Genetic Analysis of Heritable Kidney Cancer Syndromes	NCT05534854	Renal Tumor His... Kidney Cancer Renal Cell Carc... Familial Renal ... HLRCC VHL Syndrome BAP1 Tumor Pred... FLCN Gene Mutat... ALK Gene Mutati... FH Gene Mutatio... Birt-Hogg-Dube ... MET Gene Mutati... Cutaneous Leiom... Cutaneous Leiom...	Gene test	2 Years -	RenJi Hospital

Spots Global Cancer Trial Database for renal tumor histology