Researchers ID biomarkers of response to immunotherapy for kidney cancer (Easy, cheap review of pathology slides = big benefits)

Medical Xpress / Johns Hopkins University School of Medicine / Cell Reports Medicine ^ | April 6, 2023 | Julie Stein Deutsch et al

[ConservativeMind]

The number of immune cells in and around kidney tumors, the amount of dead cancer tissue, and mutations to a tumor suppressor gene called PBRM1 form a biomarker signature that can predict how well patients with kidney cancer will respond to immunotherapy, according to research.

In reviews of kidney tumor biopsies, investigators found that patients who had three positive factors—presence of immune cells in and around tumors, known as tumor-infiltrating immune cells, absence of dead cancer tissue, called necrosis, and a mutation in the PBRM1 gene—had the best overall survival at five years compared with patients who did not have this combination of factors.

Julie Stein Deutsch, M.D.: There is an unmet need for biomarkers that can help match patients to the regimens most likely to help. Such markers have not shown predictive ability in patients with kidney cancers.

The classic hematoxylin and eosin-stained (H&E) pathology slide has largely been overlooked as a possible source of biomarker information, Deutsch says.

Investigators examined H&E slides from 136 metastatic tumor samples, before treatment, from patients with renal cell cancers.

Researchers scored the specimens for the amount of tumor-infiltrating immune cells (here called TILplus) and presence of necrosis (dead tissue).

The presence of necrosis was found to modify the benefits of having immune system infiltration in the tumor.

Finally, investigators looked at mutations in the PBRM1 gene and how that impacts the other factors. A statistical analysis of all three factors found that the combination of H&E scoring with PBRM1 mutation status stratified patients into three groups.

Patients who had all three positive factors—a TILplus score of 1, necrosis score of 0 and a PBRM1 mutation—had the best overall survival at five years. Patients with two of the three features demonstrated intermediate survival, while those with only one feature had the worst survival.

[ConservativeMind]

The ability to use a simple pathology slide with their findings scaled for any new patient will allow therapy optimizations not currently known, for persons with renal cell cancer.

[ConservativeMind]

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