Dr. Kharasch said patients with other tumor types or other kidney diseases don’t have elevations in these biomarkers. He said this new urine test could potential help lower RCC-related morbidity since 10% to 15% of patients who undergo radical nephrectomy have a benign tumor.
Currently, the team is investigating a few dipstick technology applications and they hope to develop a screening test that would be similar to a mammogram or a colonoscopy.
“Studies for [U.S. Food and Drug Administration] approval and commercialization for diagnostic purposes are underway. This can take a few years,” Dr. Morrissey told Cancer Therapy Advisor.
“This test can supplement CT scans that incidentally discover a kidney mass. Since the cure for primary kidney cancer is tumor removal, further diagnosis of a renal mass discovered by imaging with these tests can avoid partial or complete removal of a kidney that has a benign mass. The tests can supplement imaging diagnostics to properly identify kidney tumors with metastatic potential.”
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Brian Rini, MD, of the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University in Cleveland, OH, wrote an accompanying commentary and writes that these new findings raised questions about the cost-effectiveness of any screening modality for RCC in the general population.2
He noted that there is a relatively low incidence of RCC in the general population, with an estimated 20 to 25 new cases per 100,000 population per year.
Dr. Rini said larger prospective trials are now warranted to validate these findings and to help better define the ultimate utility of these biomarkers. “It is promising, but there is much work left to do for this to be adopted on a larger scale,” Dr. Rini told Cancer Therapy Advisor.
- Morrissey JJ, Mellnick VM, Luo J, et al. Evaluation of urine aquaporin-1 and perilipin-2 concentrations as biomarkers to screen for renal cell carcinoma. JAMA Oncol. March 19, 2015. [Epub ahead of print] doi: 10.1001/jamaoncol.2015.0213.
- Rini BI. Urinary biomarkers for the detection and management of localized renal cell carcinoma. JAMA Oncol. March 19, 2015. [Epub ahead of print] doi: 10.1001/jamaoncol.2015.0262.