Renal cell carcinoma: the search for a reliable biomarker

Abstract

One particular challenge in the treatment of kidney tumors is the range of histologies and tumor phenotypes a renal mass can represent. A kidney tumor can range from benign (e.g., oncocytoma) to a clinically indolent malignancy (e.g., papillary type I, chromophobe) to aggressive disease [e.g., papillary type II or high-grade clear cell renal cell carcinoma (ccRCC)]. Even among various subtypes, kidney cancers are genetically diverse with variable prognoses and treatment response rates. Therefore, the key to proper treatment is the differentiation of these subtypes. Currently, a wide array of diagnostic, prognostic, and predictive biomarkers exist that may help guide the individualized care of kidney cancer patients. This review will discuss the various serum, urine, imaging, and immunohistological biomarkers available in practice.

Biomarkers of epithelial-mesenchymal transition in localized, surgically treated clear-cell renal cell carcinoma

“…In many tumors, biological markers can identify prognostic subgroups for individual treatment; however, at present, clinical use of biomarkers to predict outcome in RCC is not validated [3] and urine biomarkers as well as liquid biopsy analysis of circulating tumor DNA remain the area of active investigation [4]. The prognosis of patients with localized ccRCC and tumor metastatic potential cannot be accurately predicted by standard variables such as clinicopathological characteristics.…”

Analysis of CT features and quantitative texture analysis in patients with thymic tumors: correlation with grading and staging

“…The aim of radiomics is to evaluate the potential relationship between image and biological features of solid tumors [1] in order to access prognostic information before treatment and optimize therapeutic strategies. This approach has been recently applied to various tumors, such as glioblastoma [2][3][4], clear-cell renal carcinoma [5,6], breast, rectal and lung adenocarcinoma [7][8][9][10][11]. Recent studies also demonstrated how quantitative texture analysis (QTA) may be used to complement conventional imaging features [12][13][14][15][16][17]; however, further investigations are needed to deepen the knowledge on the relationship between radiological and biological phenotypes and to enlarge the role of radiomics in clinical practice.…”

How can biomarkers assist the prognosis of urologic malignancies?

“…MTOR pathway) have represented the substrate for the discovery and implementation of targeted therapies in advanced disease (e.g. VEGF/tyrosine kinase and MTOR inhibitors) [14].…”