A new study published in JAMA Oncology has assessed the prevalence of cancer-related germline mutations in 254 patients with advanced renal cell carcinoma (RCC). Overall, 41 participants had germline mutations, 14 of whom had mutations in syndromic RCC-related genes; the most frequently mutated genes were CHEK2 and FH. Patients with non-clear-cell RCC were more likely to have an RCC-associated gene mutation and 10.0% of these patients had a mutation that could aid therapy decisions. Clinical guidelines for genetic testing would have missed 37.5% of patients with RCC-associated gene mutations.