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Kidney cancer

Tracking and therapy selection using ctDNA

Nature Reviews Urology volume 14, page 389 (2017)Cite this article

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Despite the approval of various targeted therapies for metastatic renal cell carcinoma (RCC) over the past decade, biomarkers for allocating treatment to specific patients are lacking. The Cancer Genome Atlas (TCGA) project has enabled a deeper understanding of the genomic profile of RCC, but these data were generated from early-stage cancer, and might not translate to personalized therapy in a disease that evolves through first-line and later therapies. Thus, a biomarker that can enable longitudinal assessment of cancer genomics might be particularly valuable in RCC and enable personalization of therapy at different treatment stages. Circulating tumour DNA (ctDNA) collected from blood samples might be useful in this regard, and could be used to track tumour genomics and select next-line therapies if disease progresses.

Now, data from a recently published paper in European Urology show that the ctDNA profile in patients with metastatic RCC (mRCC) evolves with treatment. Pal and colleagues collected data from 220 patients with mRCC whose ctDNA profile was obtained using a platform of 73 cancer-related genes. Histological subtype was identified in 124 patients; 89 were clear cell (cc) tumours, 14 papillary, eight sarcomatoid, six chromophobe, four mixed, two undifferentiated, and one collecting duct. Multiple ctDNA samples had been collected at different time points for 17 patients, and treatment-related data regarding first-line or later-line therapies was available for 99 samples.

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References

  1. Pal, S. K. et al. Evolution of circulating tumor DNA profile from first-line to subsequent therapy in metastatic renal cell carcinoma. Eur. Urol. http://dx.doi.org/10.1016/j.eururo.2017.03.046 (2017)

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  1. Annette Fenner
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Fenner, A. Tracking and therapy selection using ctDNA. Nat Rev Urol 14, 389 (2017). https://doi.org/10.1038/nrurol.2017.66

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  • DOI: https://doi.org/10.1038/nrurol.2017.66

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