Dr Braun on Advancements in Biomarker Development in RCC

David A. Braun, MD, PhD, assistant professor, medical oncology, Louis Goodman and Alfred Gilman Yale Scholar, member, Center of Molecular and Cellular Oncology, Yale Cancer Center, discusses advancements in biomarker development that could help guide treatment decision-making in patients with renal cell carcinoma (RCC).

Ongoing research has continued to focus on identifying biomarkers that could help inform therapeutic decisions for patients with RCC, Braun begins, noting that this work has included genomic biomarkers, imaging-based biomarkers, and transcriptomic biomarkers. However, despite significant progress made in this realm, these types of biomarkers are not at the point where they can inform treatment decisions in clinical practice, Braun notes. Among the potential biomarkers under investigation, circulating markers such as KIM-1 also show promise, Braun emphasizes.

At the 2024 ESMO Congress, Braun and colleagues presented data from an analysis of the phase 3 CheckMate 9ER trial (NCT03141177), which showed that there may be a potential role for protein fucsosylation and sialylation mechanisms in driving resistance to nivolumab (Opdivo) plus cabozantinib (Cabometyx) or sunitinib (Sutent) in patients with advanced RCC. Notably, serum glycoproteins involved in complement cascade and lipid metabolism were found to be predictive of response to the combination of nivolumab and cabozantinib vs sunitinib in this patient population.

He acknowledges detecting sarcomatoid histology stands as a notable exception in terms of biomarkers that can currently be used to drive treatment decisions in clinical practice for patients with RCC, explaining that this histology can be assessed through histologic examination under the microscope. Sarcomatoid features have been associated as predictive value in determining which patients may respond better to immunotherapy compared with targeted therapy, Braun explains.

The ultimate goal of ongoing research is to collect more data regarding other potential biomarkers that could eventually be utilized in clinical practice, and some of the potential biomarkers identified through research thus far could eventually make an impact of treatment decisions in a real-world setting, Braun concludes.