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A study has shown that a simple urine test could detect the return of kidney cancer, spare patients from having frequent CT scans and speed up access to treatment. The findings from the study were presented at the European Association of Urology (EAU) Congress in Madrid this week and will be published in European Urology Oncology.
The test looks for substances called glycosaminoglycans which are found in urine. The test is called the GAGome test. The study (called AURORAX-0087A) looked at whether the GAGome test can accurately detect the return of clear cell kidney cancer after surgery to remove the cancer. Around one-fifth of kidney cancer patients who have surgery to remove their cancer will see it return within five years – the majority within the first two years. Currently, the only way to monitor patients is by using a CT scan every 6 to 12 months.
The study involved 134 patients diagnosed with clear cell kidney cancer which had not spread beyond the kidney, and which was treated with surgery. Most had their kidney completely removed (radical nephrectomy). All patients continued to have CT scans as standard monitoring after surgery, alongside a urine test every 3 months. Each urine sample was analysed and given a score out of 100, called the GAGome score. A GAGome score above 12 was counted as positive for return of the cancer, and 12 or below as negative. The higher the GAGome score, the more likely the positive result correctly identified recurrence.
After up to 18 months of follow-up, the cancer returned in 15% of patients. The GAGome test correctly identified 90% of patients whose cancer had returned. This level of accuracy is similar to CT scans.
“CT scans often pick up small lesions that aren’t large enough to biopsy, and we currently don’t know whether they are a sign of the cancer returning or not,” explained the researchers. “Our only option is to do more frequent scans to monitor more closely, which is unpleasant for patients and often brings little benefit.
“If you have a urine test that can accurately show whether the cancer has actually returned then you can better assess risk levels and reduce the frequency of the scans required. Based on the results we have so far, it’s likely that we could safely halve the number of scans that patients have to undergo.”
The GAGome test is under development by Swedish diagnostics company, Elypta. The test has not yet been approved for clinical use and further research is needed to confirm its effectiveness in clinical practice.
