Resident Physician Cedars-Sinai Medical Center, Department of Surgery, Division of Urology
Introduction: Among patients with renal cell carcinoma (RCC), those of Hispanic ethnicity have worse disease burden. Hispanic patients (HP) are diagnosed at a younger age and have higher stage disease at diagnosis. Although some of the disparity is due to social factors, studies have shown differences in RCC histologic subtype between HP and non-Hispanic white patients. This suggests a potential molecular component conferring greater pre-treatment disease. HP have been underrepresented in molecular genomic studies of RCC and data on gene variation are lacking. Here, we aim to determine differences in germline and somatic alterations in HP and non-Hispanic patients (NHP) with RCC. Methods: We queried a multi-institutional pan-cancer database of > 5 million patients for patients aged =18 diagnosed with RCC. Demographic factors and disease-specific factors were compared between HP and NHP to assess for statistical significance (p < 0.05). Frequency and type of germline and somatic alterations were compared. Results: We identified 558 HP and 4829 NHP with RCC. No difference in gender distribution was observed. HP were younger at diagnosis (57.3 years vs 61.4 years in NHP) (p < 0.001) and more likely to be diagnosed at or before age 46 (20% vs 11% in NHP) (p < 0.001). Fifty-seven percent of HP reported being never smokers compared to 40% of NHP (p < 0.001). A higher proportion of HP presented with T4 or T3 disease (75%, compared to 43% of NHP). Overall, somatic variant information was available for 166 HP and 667 NHP; germline variant information was available for 38 HP and 667 NHP. The most common somatic and germline variants in HP and NHW are shown in Figure 1. Overall, somatic alterations appeared commensurate with the general RCC population. HP showed higher rates of germline alterations in CHEK2, MSH6, FH, and FLCN compared to NHP. Conclusions: Differences in germline alterations are observed between HP and NHP with RCC. Further genomic studies that include HP are needed to better identify targetable genetic alterations and improve treatment decisions. SOURCE OF Funding: None
