Maxine Sun, PhD, MPH, research scientist, Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, research consultant, Brigham and Women's Hospital, discusses ongoing research efforts dedicated to examining the relationship between clonal hematopoiesis and cardiovascular disease in patients with renal cell carcinoma (RCC).

Data from a study presented at the 2023 ASCO Annual Meeting indicated that patients with clonal hematopoiesis were at a higher risk of death from cardiovascular disease and coronary artery disease. Sub-analyses revealed that this risk was higher in those with RCC who harbored somatic mosaic chromosomal alterations, suggesting that clonal hematopoiesis could represent a relevant potential risk factor in this disease.

Investigators at Dana-Farber Cancer Institute received a grant to further explore these events in patients with kidney cancer. Specifically, they hope to explore some of the genetic correlations between hematopoietic phenotypes and RCC to determine whether there is similar genetic architecture, according to Sun; this could help identify some key pathways, she adds.

Additionally, investigators hope to replicate an association that was previously observed in population-based data, which suggested that clonal hematopoiesis, or more specifically, mosaic chromosome alterations, is still associated with cardiovascular disease in different population-based settings, Sun expands. Next steps will be to examine institutional databases, as well as other real-world findings to determine whether that effect can be replicated, Sun adds.

Efforts are also underway to better understand whether there are certain inflammatory markers that are associated with carriers of clonal hematopoiesis, Sun continues. Preliminary research has suggested that patients with clonal hematopoiesis tend to have higher levels of high-sensitivity C-reactive protein, which is a traditional marker for inflammation. This observation could be revisited in a database that contains more inflammatory markers, and may reveal additional insights on this association, Sun concludes.

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Maxine Sun, PhD, MPH, discusses ongoing research efforts dedicated to examining the relationship between clonal hematopoiesis and cardiovascular disease in patients with renal cell carcinoma.

Dr Sun on Ongoing Research Efforts Examining Clonal Hematopoiesis in RCC

Maxine Sun, PhD, MPH, research scientist, Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, research consultant, Brigham and Women's Hospital, discusses the association between clonal hematopoiesis and cardiovascular disease in patients with renal cell carcinoma (RCC).

Clonal hematopoiesis occurs when a mutation in the hematopoietic system provides a cell with a survival advantage over normal cells, allowing for its clonal expansion, Sun begins. This phenomenon is commonly driven by somatic mutations in known oncogenes and tumor suppressor genes or by somatic mosaic chromosomal alterations.

Prior research has established that clonal hematopoiesis is associated with a high risk of developing hematologic malignancies, Sun continues. However, an increasing body of evidence in the past few years indicates that clonal hematopoiesis is causally linked with cardiovascular disease when driven by certain mutations, Sun adds. Accordingly, it is considered a new cardiovascular risk factor.

A prospective cohort analysis of patients with a cancer diagnosis in the UK Biobank was conducted to identify the effect of somatic mosaic chromosomal alterations on cardiovascular disease, Sun details. These alterations were characterized using DNA genotyping array intensity data and long-range chromosomal phase inference. The risk of death caused by cardiovascular disease, death by coronary artery disease, death of cancer causes, and death of any cause were all evaluated. Exploratory end points included the risk of various incident cardiovascular phenotypes.

The study revealed that patients with clonal hematopoiesis were at a higher risk of death from cardiovascular disease and coronary artery disease, Sun reports. Sub-analyses revealed that this risk was higher in patients with somatic mosaic chromosomal alterations who had RCC, Sun concludes. This indicates that clonal hematopoiesis may be a relevant potential risk factor in this disease.

Maxine Sun, PhD, MPH, discusses the association between clonal hematopoiesis and cardiovascular disease in patients with renal cell carcinoma 

Maxine Sun, PhD, MPH

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Dr Sun on Ongoing Research Efforts Examining Clonal Hematopoiesis in RCC

Dr Sun on the Relationship Between Clonal Hematopoiesis and Cardiovascular Disease in RCC