Marc Machaalani, MD, on soluble MAdCAM-1 in metastatic renal cell carcinoma

Data presented at the 2025 European Society for Medical Oncology (ESMO) Congress in Berlin, Germany suggest that soluble MAdCAM-1 may serve as a predictive biomarker in patients with metastatic renal cell carcinoma (mRCC).¹

Specifically, data showed that a higher level of soluble MAdCAM-1 at baseline was associated with prolonged progression-free survival (HR, 0.75; 95% CI, 0.59 to 0.96; P = .021) and overall survival (HR, 0.59; 95% CI, 0.41 to 0.85; P = .004). These trends remained even after adjusting for IMDC risk groups.

Presenting author Marc Machaalani, MD, sat down with Urology Times® at ESMO to describe the key takeaways from this study. Machaalani is a postdoctoral research fellow at Dana-Farber Cancer Institute in Boston, Massachusetts.

In total, the study included 1051 patients. Data for the training cohort were obtained from the phase 3 JAVELIN Renal 101 trial (NCT02684006), and data for the validation cohorts were collected from the phase 2 SURF (NCT02689167) and NIVOREN trials (NCT03013335).

Results from the study also showed that patients who experienced an increase in soluble MAdCAM-1 levels from baseline to the C3 visit were more likely to have a response to therapy (OR, 1.88; 95% CI, 1.34 to 2.65; P < .001). Further, immunotherapy-based regimens were linked with an increase in soluble MAdCAM-1 levels (P < .001, all cohorts), but tyrosine kinase inhibitors (TKI) alone were associated with a reduction in soluble MAdCAM-1 (P < .01).

Overall, the authors concluded, “Our study supports a paradigm shift in the management of mRCC, paving the way to biomarker-guided clinical trials investigating microbiota-targeted interventions aimed at enhancing the efficacy of standard ICI-based therapies.”

REFERENCE

1. Machaalani M, Silva AC, Saliby RM, et al. Soluble MAdCAM-1 predicts outcomes in patients with metastatic renal cell carcinoma: Results from three independent clinical trials. Presented at: European Society for Medical Oncology Congress. October 17-21, 2025. Berlin, Germany. Abstract 2599MO. https://s3.eu-central-1.amazonaws.com/m-anage.com.storage.esmo/static/esmo2025_abstracts/2599MO.html.pdf