Analysis of gene-expression profiles of kidney renal papillary cell carcinoma (KIRP) samples revealed a group of 15 immune-related genes that correlate with survival outcome and may contribute to understanding which patients may respond to new therapeutic approaches such as immunotherapy.

The study, published in Cancer Medicine, used bioinformatics to interrogate data from 285 KIRP samples in The Cancer Genome Atlas (TCGA) to identify immune-related genes that were correlated with overall survival.1,2 The researchers input 1534 immune-related genes into their analysis to construct the signature, ultimately focusing on a group of 15 genes that they said independently predicted the survival outcome of patients with KIRP.

“In general, I thought it was a very interesting paper. There’s a lot more work that needs to be done, but this is a good starting point,” said Chung-Han Lee, MD, PhD, an oncologist specializing in kidney cancers from Memorial Sloan Kettering Cancer Center in New York. For the rarer types of kidney cancer, a main challenge is this rarity — and a related challenge is the diversity of the malignancies within this subset.

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The major type of kidney cancer and, hence, focus of the majority of renal cell carcinoma (RCC) research so far has been clear cell cancers, which make up approximately 70% of all cases. KIRP is much rarer, developing in 10% to 20% of patients, and is a highly heterogeneous disease, both histologically and in terms of prognosis.3,4 Despite these differences, it is often treated with many of the same drugs as other subtypes, consisting of mostly antiangiogenesis agents and mTOR inhibitors although some novel small-molecule inhibitors are currently under evaluation in clinical trials, such as agents that target the MET kinase ( Identifier: NCT02019693).

“We collectively group tumors as papillary, but even in this we know there are different natural histories of papillary. Aggressive and indolent types can currently be classified together. There needs to be further refining of the classification systems – at some point when we know more, these type of profilings may help us with these groupings and better selecting them for treatment,” said Dr Lee.