Molecular Pathology of Genitourinary Cancers: Translating the Cancer Genome to the Clinic

Genitourinary malignancies, including cancers of the prostate, urinary bladder, kidney, testis, and penis, are major causes of cancer morbidity and mortality. Molecular classification and predictive and prognostic assays have historically lagged other cancer types. Nevertheless, high-throughput technologies combined with large international efforts to comprehensively interrogate cancer genomes and transcriptomes have dramatically increased our molecular knowledge of these tumors. In parallel, novel treatments have been approved for several advanced genitourinary cancers, further driving need to identify prognostic and predictive biomarkers. The shift toward precision medicine, selecting the right therapy for the molecular alterations driving a patient’s particular cancer, portends a rise in clinical demand for routine cancer genome/transcriptome assessment. Here, we provide an overview of the range of driving genetic alterations in common genitourinary cancers. We focus on salient single genes, multigene panels, and findings from exome-/genome-wide interrogation and discuss their potential for translation into clinical assays in the context of available therapies.