b'entity is frequently metastatic at presentation, withand researchers.~75%ofcases staged aspT3 orpT4at nephrec- WhilemolecularclassificationofRCChas tomy. Guidelines recommend weighing use of ero- increased diagnostic complexity and engendered need lotinibandbevacizumaborimmunotherapy-basedfor resources in ancillary testing, review of the cur-treatments for metastatic disease.rent and emerging management considerations of the Succinate dehydrogenase (SDH)-deficient RCC:tumors described herein supports the clinical value of Averyraresubtype,SDH-deficientRCCisoftentheir recognition and diagnosis to patients, patholo-diagnosed in patients in their 30s. Fortunately, surgerygists, and urologic oncologists, said Smith, Hampton is frequently curative, the authors noted. andcolleagues.Oneadditionaladvantageofthis Anaplastic lymphoma kinase (ALK)-rearrangednew category of tumors bears mention as wellthe RCC:Therearetwosubtypesof ALK-rearrangedconceptual separation of diagnostic categories from RCCwithonecharacterizedbyafusionbetweensyndromic terms.vinculin and ALK and the second by rearrangements1Kanakaraj J, Chang J, Hampton LJ, Smith SC. The New WHO between ALK and other partners. The subtypes differCategory of Molecularly Defined Renal Carcinomas: Clinical and in location, histology and demographic distribution,Diagnostic Features and Management Implications. Urol Oncol. 2024 with the VCL::ALK fusion subtype typically appear- Mar 21:S1078-1439(24)00333-8. doi: 10.1016/j.urolonc.2024.02.003.ing in the renal medulla and predominant in patients of Africandescentwhohavesicklecelltrait.TheOverall Survivalsecond subtype appears to be more aggressive with(Intention-to-Treat Population)one-third of patients exhibiting metastases at diagno-sis. It also seems to disproportionately affect of East Asiandescent.Management-wise,surgicalresec-tion is indicated for local disease, though in systemic disease, treatment with ALK kinase inhibitors such as entrectinib has shown very promising results, the researchers said.SWI/SNFRelated,MatrixAssociated,Actin DependentRegulatorofChromatin,Subfamily B, Member 1 (SMARCB1)-deficient renal medul-lary carcinoma: A particularly rare and extremely aggressivecancerthatalmostexclusivelyaffects patients carrying the sickle cell trait, with a predilec-tion for males, SMARCB1-deficient renal medullary carcinoma frequently is first diagnosed at stage IV and has a mortality rate of 95%, with median survival time of about 14 months, Smith, Hampton and colleagues noted. If resection is possible, radical nephrectomy withretroperitoneallymphnodedissectionisrec-ommended with metastatic disease treated with sev-eral combinations of conventional cytotoxic agents, although consideration of clinical trial participation is urged given recent rapid growth of understanding ofthemolecularbiologyofthesemostaggressive renal tumors, the authors added. A number of trials are in process for this tumor type.Whileclearrecommendationsfortreatmentare not yet available given the recent characterization ofSource: Severity of Respiratory Syncytial Virus vs. COVID-19 molecularly defined RCC and their relative rarity, theand Influenza Among Hospitalized US Adults. JAMA Netw Open. newclassificationstillprovidesvaluetoclinicians2024;7(4):e244954. doi:10.1001/jamanetworkopen.2024.495463'