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Immunotherapy medicines have dramatically changed the way advanced (metastatic) kidney cancer is treated. There have been many studies looking at biomarkers for kidney cancer. Biomarkers are natural substances, genes or characteristics (e.g, blood pressure) that can be measured by which a particular biological process or disease can be identified. Biomarkers are often used to assess a biological response to treatment and to give an indication of the best treatment to give a patient.
To date, there have been many studies looking at biomarkers to predict the effectiveness of immunotherapies for metastatic kidney cancer. However, none have been very reliable and not easy to measure in the real world.
In this study a number of potential biomarkers were looked at in tumour tissue. The researchers identified certain immune cells, called CD8-positive T cells and CD68-positive macrophages in the tumour tissue. This indicated a favourable response to immunotherapy treatment. However, high numbers of CD4-positive T cells indicated a poor response to immunotherapy. This provides an accurate biomarker in patients with metastatic kidney cancer. By looking at tumour tissue the outcome of immunotherapy treatment could be predicted by looking at the immune cells in the tumour.
Another study looked at the relationship between the combination of platelets (a protein found in the blood) and the ratio between two types of white blood cell (neutrophil-lymphocyte ratio) at the time of adverse events during sunitinib treatment when outcomes are unclear. This study showed that within the first 6 weeks of sunitinib treatment measurement of this ratio could predict survival more accurately than when measured at the start of sunitinib treatment. This will be useful in decision-making to continue sunitinib in the early treatment stages of patients with metastatic kidney cancer.
This last study looked at the ratio of two white blood cells, neutrophils-to-lymphocytes, as well as platelets-to-lymphocytes to investigate the role of inflammation in cancer and the growth of tumours. In recent years, many inflammatory biomarkers showed promise in predicting outcomes in kidney cancer. These ratios have shown promising results before surgery. The study showed that the ratios of these blood cells and platelets can become part of routine investigations for all kidney cancer patients patients, and may help to predict outcomes, chance of recovery, recurrence, and survival rates. Further studies are needed to confirm this.