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An educational symposium was held from 8-10 August as part of the American Society of Clinical Oncology’s (ASCO) Annual Meeting. In his presentation, Dr McGregor from the Dana-Farber Cancer Institute, Boston, USA describes prognostic biomarkers that give an indication of the outcome of the patient on a particular treatment, and predictive biomarkers that predict a favourable or unfavourable effect from a treatment.
Currently, biomarkers/clinical predictors fall into two categories:
- Clinical, such as RCC risk categories (favourable, intermediate or poor), neutrophil-lymphocyte ratio, PD-L1 status, and sarcomatoid and rhabdoid histology
- Genomics, such as sequencing to assess tumour mutational burden and PBRM1 status, genomic signatures, and metabolomics.
Dr McGregor went on to talk about the clinical trials investigating the various biomarkers for metastatic renal cell carcinoma (RCC) and its treatments. For example, the SAVOIR study looked at MET in patients with metastatic papillary RCC, CheckMate 214 and KYENOTE-426 investigated risk categories, and other studies looked at neutrophil-lymphocyte ratio and PD-L1 status as prognostic biomarkers (CheckMate-025 and KEYNOTE-426).
He discussed biomarkers for sarcomatoid RCC and the data from the COMPARZ and RECORD3 trials, which looked at the PBRM1 biomarker. Gene signatures from ImMotion 150 and Javelin RENAL 101 were also assessed.
Metabolomics (the large-scale study of small molecules, commonly known as metabolites, within cells, biological fluids, tissues or organisms) have also been assessed as potential biomarkers for RCC.
In conclusion, Dr McGregor provided the following take-home messages:
- There are multiple prognostic markers
- What works for other tumours does not work in RCC
- There are exciting “potential” predictive biomarkers, such as genomics (not tumour mutational burden), metabolomics
- One size fits all does not fit for RCC.