New Method for Predicting Treatment Response in Metastatic Renal Cell Carcinoma is Discovered by Study

By incorporating the level of inflammation, which was assessed using two straightforward blood parameters, alongside the conventional imaging-based approach, Dr. Niklas Klümper, resident at the Department of Urology and Pediatric Urology of the University Hospital Bonn (UKB) and working group leader at the Institute for Experimental Oncology (IEO), and Dr. Jonas Saal, resident at the Medical Clinic III for Oncology, Hematology, Immune-Oncology, and Rheumatology of the UKB, , exhibited a notable improvement in predicting the response to therapy in metastatic renal cell carcinoma.

The most prevalent type of kidney cancer is renal cell carcinoma. Combinations of immunotherapies are the first line of treatment for metastatic renal cancer. These are made to make the immune system of the patient work harder to find and kill cancerous cells. Over 80% of patients with metastatic renal cell carcinoma are currently controlled by these highly effective first-line therapies.

Limitation of imaging

For the best patient care, accurate predictions of how a patient will respond to treatment are essential. However, in routine clinical practice, only imaging—typically computed tomography (CT)—that provides an imprecise estimation of the volume of the tumor is utilized to evaluate treatment response. However, based solely on tumor volume, it is not possible to accurately predict which patients will benefit from immunotherapy over time. Therefore, in order to further optimize and direct therapy, complementary markers that can anticipate further disease progression are essential.

Improvement of the therapy response in the blood

The research group led by Dr. Klümper has now had the option to show that the examination of two economical and generally accessible inflammatory markers in the blood (C-receptive protein (CRP) and albumin) fundamentally works on the forecast of treatment reaction in patients with metastatic renal cell carcinoma, particularly in the enormous gathering of patients with infectious prevention in the first development (>80%). The authors came to the conclusion that in the future, patients with metastatic renal cell carcinoma should be monitored using both radiologic imaging and complementary analysis of inflammation levels.

“Our novel approach for enhanced therapy monitoring and prediction of treatment response is based on the combination of imaging and the assessment of inflammation level through the collection of two simple blood parameters: CRP and albumin integrated into the well-known modified Glasgow Prognosis Score (mGPS). Our study’s findings are derived from patient cohorts participating in two separate randomized trials focused on metastatic renal cell carcinoma. These results strongly advocate for the immediate implementation of the mGPS as a prognostic tool for predicting outcomes in individuals diagnosed with metastatic renal cell carcinoma”, said.

Dr. Niklas Klümper, a resident at the University Hospital Bonn’s Department of Urology and Pediatric Urology.

The mGPS is determined by assigning one point for an elevated serum CRP concentration (> 10 mg/L) and, only in patients with elevated CRP, a second point for decreased serum albumin (< 35 g/L). Patients are then categorized as low risk (0 points), intermediate risk (1 point), and high risk (2 points).

“Both blood parameters are widely available and inexpensive to determine, and thus can be immediately integrated into clinical practice worlwide to improve therapy monitoring of cancer patients. Improved prediction of treatment failure could better identify patients who could benefit from a change or intensification of therapy. This concept needs to be explored in future studies,” said Dr. Jonas Saal.