Dr Uzzo on a Biomarker Analysis of the IMmotion010 Trial in RCC

Robert Uzzo, MD, MBA, FACS, G. Willing “Wing” Pepper Chair in Cancer Research, president, chief executive officer, Fox Chase Cancer Center; executive vice president, Cancer Services, Temple University Health System; senior associate dean, Clinical Cancer Research, Lewis Katz School of Medicine, Temple University, discusses results from a biomarker analysis of the phase 3 IMmotion010 study (NCT03024996) investigating adjuvant atezolizumab (Tecentriq) in patients with renal cell carcinoma (RCC). Findings from this analysis were presented at the 2024 ASCO Annual Meeting.

IMmotion010 was a major adjuvant study in kidney cancer, where patients were randomly assigned to receive either atezolizumab for 1 year or placebo for the same duration, Uzzo begins. The objective was to reduce the risk of cancer recurrence. The study included patients with intermediate- or high-risk kidney cancer, specifically those with grade 4, T2, or more severe disease, including metastatic disease that could be surgically resected, he explains. Importantly, all patients underwent complete resection of their tumors before random assignment, Uzzo adds.

The main aim of this research was to determine whether immediate adjuvant immunotherapy could lower the recurrence risk and improve disease-free survival (DFS) in this population vs placebo, Uzzo reports. Unfortunately, the study results indicated that adding atezolizumab did not enhance DFS. However, the study included a substantial number of serum samples, he says. Researchers analyzed these samples, focusing on various expressions of KIM-1 in the plasma, to assess whether KIM-1 could serve as a circulating biomarker for better patient identification, Uzzo explains.

The findings revealed that a high baseline level of KIM-1 was associated with a poorer DFS rate across the overall cohort, Uzzo expands. Specifically, patients with higher KIM-1 levels at baseline tended to experience more frequent recurrences, he says. Additionally, among patients with elevated KIM-1 levels at baseline, those who received atezolizumab had better outcomes compared with those with lower KIM-1 levels, Uzzo concludes. Notably, the subgroup of patients with high pre-operative KIM-1 levels experienced an approximate 28% improvement in DFS when treated with atezolizumab compared with placebo.