In this episode, Dr. Aditya Bagrodia is joined by Dr. Ari Hakimi and Dr. Nirmish Singla to explore the growing role of germline testing in renal cell carcinoma (RCC). The discussion highlights how recent large-scale testing efforts have revealed that hereditary kidney cancer is more common than traditionally believed, with 8–10% of cases linked to inherited mutations. The experts review key syndromes—such as von Hippel–Lindau (VHL)—their extrarenal manifestations, and the importance of detailed family histories and targeted physical exams in identifying patients who may benefit from testing.
The conversation also addresses common patient misunderstandings between germline and somatic testing, the value of genetic counselors and medical geneticists, and guideline-based triggers for testing, particularly in younger patients. The physicians discuss how germline findings can influence surgical planning, including precision approaches and considerations for lymph node dissection. They also touch on emerging therapeutics like belzutifan for VHL-associated tumors and share perspectives on how tumor sequencing and hereditary insights are shaping the future of RCC management.
Contributors:
Dr. Aditya Bagrodia is an associate professor of urology and GU oncology at UC San Diego Health and adjunct professor of urology at UT Southwestern.
Dr. Ari Hakimi is a urologic surgeon at Memorial Sloan Kettering Cancer Center in New York City.
Dr. Nirmish Singla is the director of translational research in genitourinary oncology at Johns Hopkins University in Baltimore, Maryland.
