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 are routinely applied in the workup of patients with hematologic malignancies and more recently in those with some types of solid tumors. Unfortunately, clinical translation of molecular findings in genitourinary cancers has lagged behind with only few molecular assays being used in the clinic. Nevertheless, high-throughput technologies combined with large international efforts to comprehensively interrogate cancer genomes and transcriptomes will likely lead to a complete cataloguing of the aberrations present in genitourinary cancers within just a few years. The shift towards 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.