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Mechanisms of Somatic Mutation and Tumor Initiation in Pre-malignant Kidney Tubule Cells

Recruiting
Conditions
Carcinoma, Renal Cell
Von Hippel-Lindau Disease
Interventions
Other: Blood and urine sample collection
Registration Number
NCT06194669
Lead Sponsor
IRCCS San Raffaele
Brief Summary

The goal of this observational study is to analyze somatic mutations in the genome of normal kidney cells from patients affected by kidney cancer predisposition syndrome Von Hippel Lindau (VHL) and compare the mutation rates observed in these patients and in individuals not affected by the disease. The main questions the study aims to answer are:

* Do kidney cells from VHL patients mutate more than cells from control individuals during adult life?

* What mechanisms favor somatic mutation occurrence in the genome of normal kidney tubule cells?

Participants will donate one blood sample and multiple urine samples. Urines will be used for kidney cell isolation, followed by cell culturing and genetic analyses. Urine samples will be collected once a year for 3-5 years. Sample collection will occur during the yearly screening program that each patient undergoes at the hospital. In case patients undergo surgical treatment of kidney tumors, samples discarded from surgery (tumor and normal kidney adjacent to tumor) will be collected and subjected to genetic analyses.

Researchers will compare the number and types of mutations found in tumors and normal kidney cells from VHL-disease patients with those found in normal kidney cells from control individuals, to see if somatic mutation rates are increased in VHL-disease patients during aging.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
50
Inclusion Criteria
  • Genetic diagnosis of VHL-disease; age (data need to be collected from a population distributed between 25 and 65 years); gender (males and females should be equally represented);
Exclusion Criteria
  • patients with bilateral nephrectomy, in dialysis or kidney transplant; use of nephrotoxic drugs

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
ControlsBlood and urine sample collectionHealthy volunteers; patients referring to San Raffaele Hospital for renal/urological conditions other than VHL
VHL-disease patientsBlood and urine sample collectionIndividuals with genetic diagnosis of Von Hippel Lindau disease
Primary Outcome Measures
NameTimeMethod
Rate of somatic mutation accumulation in normal kidney tubule genomesNormal kidney tubule cells from urines are assessed from control and VHL-disease patients typically over a period of 3 years (min 3 months, max 3 years)

The genome of multiple normal kidney cells from each subject will be investigated by whole genome sequencing. The number of somatic mutations per genome will be plotted according to donor's age and a curve describing the accumulation of mutations with age will be obtained for both the control and VHL-disease patient populations. The aim is to assess differences in mutation rates in the kidney of VHL-disease patients vs controls and understand the underlying mechanism.

Secondary Outcome Measures
NameTimeMethod
Quantification of pre-cancer cells in urinesNormal kidney tubule cells from urines are assessed from control and VHL-disease patients typically over a period of 3 years (min 3 months, max 3 years)

From each urine sample, researchers can culture up to 20 single cell clones and perform a single-clone, gene-expression analysis. The expression of markers that characterize the mutation-prone, pre-cancer population will be assessed in all clones. The fraction of clones expressing markers of pre-cancer cells will be calculated in control and VHL-disease groups. The aim is to assess any differences in the presence of pre-cancer cells in urines from VHL-disease patients vs controls and assess any correlation of this parameter with kidney cancer occurrence.

Trial Locations

Locations (1)

IRCCS Ospedale San Raffaele

🇮🇹

MIlan, Italy

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