‘Absolutely Important’ to Develop Better Ways to Predict Kidney Cancer Recurrence, Says Expert

Future research must address ways to improve the prediction of kidney cancer recurrence to better inform patients, says an expert from the Royal Free London NHS Foundation Trust.

Questions concerning disease recurrence among patients with renal cell carcinoma—a type of kidney cancer—need to be answered with future research, according to Axel Bex, MD, PhD, a urologic surgeon at the Specialist Centre For Kidney Cancer, Royal Free London NHS Foundation Trust, and a professor at University College London, Division of Surgery and Interventional Science.

During the 2022 Society for Urologic Oncology (SUO) Annual Meeting, CancerNetwork® spoke with Bex about his presentation on new developments in adjuvant therapy for renal cell carcinoma.

Bex also said that the use of gene-expression profiles as predictive biomarkers of treatment response is another development in the field that is being explored in the BIONIKK trial (NCT02960906), which is evaluating nivolumab (Opdivo) and ipilimumab (Yervoy) in metastatic kidney cancer. Reducing the rate of overtreatment for metastatic kidney cancer is another important challenge, according to Bex.


First of all, we know from the metastatic setting that there are certain molecular subtypes that seem to predict that these patients respond better to immunotherapy, but they haven't made it into general practice yet as biomarkers. But as we heard here at SUO, there are some trials being planned.

We also have the BIONIKK trial in Europe, for example, that would look at certain gene expression profiles, and select patients who are much more likely to respond. Now, what we need to avoid in the future is there's a 40% over-treatment rate. That's something we already learned from [tumor growth inhibition] trials. It is absolutely important that we improve our prediction of recurrences. Patients want to know: do [my diseases] recur? And if so, is there something that helps me? And if there's something that helps me, is it likely that I will respond to it? These 2 questions need to be answered, and I think we have the tools.

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