Identifying prognostic biomarkers remains a vital area of study in renal cell carcinoma, according to Kerstin Junker, MD, PhD, who adds that it is important to recognize the various subtypes of RCC when making individualized treatment decisions for patients.
, Junker, associate professor, Department of Urology, Universität des Saarlandes, and chair of the European Association of Urology Section of Urological Research, discussed the need to identify prognostic biomarkers for patients with RCC.
OncLive: What are some key things to note about subtyping RCC?
In RCC, there are different subtypes of the disease, not just one. Therefore, it is important to understand that we have different entities that have different biology, prognosis, and outcomes. The first thing that we should do is look at each subtype separately and investigate biological approaches in order to find targets for therapy and identify biomarkers that can predict outcomes.
Currently, this is a gap in patient care because oncologists are saying that we do not have good markers, which is not true. However, we have to step forward and prove them in trials.
Are there clinical trials investigating markers or does this remain an unmet need?
There are not many clinical trials that are investigating this. I would say there are no movements to test markers. It is a problem. If you want to introduce a new therapy, there are companies that can finance these trials. However, if you want to introduce a marker, then there is no interest from most companies; therefore, we need another form of financing. It is important research, but there are not very good standards for testing markers. As I said, it is difficult to find sponsorship for those trials. In Germany, we have official organizations that can provide that financing, so we are working on developing those trials.
What is the next step in terms of research?
We have to prove the benefit of these prognostic biomarkers. This is the first step. Several studies are investigating adjuvant therapies. Some trials have shown that there is no effect for using tyrosine kinase inhibitors, but we would like to test the effectiveness when we use these molecular prognostic markers. Then, if you could identify patients who are high risk, you might be able to see more of a difference. That is one way that we can improve.
We could also make improvements in clinical trials. In the future of adjuvant trials, such markers should be used to see if there is an advantage in a certain selection of patients and the effect of these therapies. However, we have to do prospective testing of the markers and signatures that we currently have.
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