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Role of Biomarkers in Prediction of Response to Therapeutics in Metastatic Renal-Cell Carcinoma

  • Jacob J. Adashek 1,
  • Meghan M. Salgia 2,
  • Edwin M. Posadas 3,
  • Robert A. Figlin 3,
  • Jun Gong 3
1 Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, Pomona, CA 2 Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA 3 Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA

Publication: January, 2019

DOI: https://doi.org/10.1016/j.clgc.2019.01.004

Renal-cell carcinoma remains one of the elusive cancers that lacks a biomarker. It is the eighth most commonly diagnosed malignancy in the United States, and the incidence has slowly trended upward. In addition to the increase in newly diagnosed cases, the prevalence and overall survival of individuals with kidney cancer also has increased substantially. This formal review synopsizes the literature regarding the current treatment landscape, the utility of biomarkers in renal-cell carcinoma, and future directions regarding next-generation sequencing of circulating tumor DNA.

Commented by Dr. Jacob J. Adashek

This formal review synopsizes the literature regarding the current treatment landscape for metastatic renal cell carcinoma (mRCC). It reviews the evidence from the most recent mRCC trials: CABOSUN, CheckMate 214, IMmotion151, and JAVELIN Renal 100. It further discusses, the utility of biomarkers in renal cell carcinoma, particularly genes that were found to have significance from retrospective data from the RECORD-3 trial, studies from mTOR pathway treated patients, and the utility of PD-(L)1, as well as current state of the microbiome impact on treatment. Last, it covers future directions regarding next-generation sequencing of circulating tumor DNA and how this can further inform treatment decisions for patients.