“It's important to note as well that the kidney cancer biology is really distinct from a lot of other solid tumors, and particularly other immunotherapy response to solid tumors,” says David A. Braun, MD, PhD.
In this video, David A. Braun, MD, PhD, recaps the session, “Update on Biomarkers in Renal Cell Carcinoma,” which was presented at the 2024 ASCO Genitourinary Cancers Symposium in San Francisco, California. Braun is an assistant professor of medical oncology at Yale Cancer Center in New Haven, Connecticut.
The first question I'd ask is why do we need biomarkers? When we didn't have effective therapies for kidney cancer 15 or 20 years ago, the concern or question about biomarkers wasn't even there. Now that we're in the fortunate position where therapy has evolved tremendously, where we have multiple options for first-line treatment [and] adjuvant therapy for kidney cancer, there are some natural questions that evolve. Which is the right therapy for my patient? Is this therapy going to work? Does my patient need therapy at all? [That's] particularly relevant in the adjuvant setting. [Also,] questions like, is my patients going to get side effects or toxicity? These are where biomarkers could be really helpful.
I think it's important to note as well that the kidney cancer biology is really distinct from a lot of other solid tumors, and particularly other immunotherapy response to solid tumors. What we've learned over and over again with kidney cancer is that we just can't extrapolate from other cancer types. If something was a good biomarker in melanoma or non-small cell lung cancer, that does not necessarily translate into something that's going to be a good biomarker in kidney cancer.
So, with that background, my hope for the talk was to give a little bit of a framework and a taste of what the different approaches and types of biomarkers are, including ones that we are examining today, ones that are a little bit further along, and a little bit of what's coming in the future, what are the exciting things, and to provide a framework for how to think about those. Among current biomarkers, we've thought about everything from histology–being able to just look under the microscope, which has been around for a long time–to slightly more advanced cell phenotyping, things like immunofluorescence, where we're able to see what the specific cell types are within a tumor, to more genomic approaches, and ultimately, even transcriptomic approaches. All of those are being actively explored within kidney cancer. Then [I discussed] some emerging areas as well as we get into the era of single cell RNA sequencing and spatial technologies, even biological functional modeling. How can we think about these in the context of kidney cancer biomarkers?
This transcription has been edited for clarity.