Determinants of resistance in metastatic renal cell carcinoma.

FECRI scientists Professor Nuzhat Ahmed, Professor George Kannourakis, PhD candidate Dr Revati Sharma and Dr Prashanth Prithviraj have have published research into Renal Cancer-‘Determinants of resistance to VEGF-TKI and immune checkpoint inhibitors in metastatic renal cell carcinoma’ in Journal of Experimental & Clinical Cancer Research.

Renal cancer is cancer of the kidneys.  Kidneys are essential organs located at both sides of our body, which remove waste from our blood, control body fluid, electrolyte balance and regulates blood pressure.

Renal cancer is rare and constitutes only 3% of adult cancers.  The average survival time is 3 years.  Lack of biomarkers make early detection of this disease difficult.  However, if detected early it is curable.

The cancer is genetically complex which makes it hard to treat.  In the last two decades, several drugs (TKIs), which inhibit small blood vessels that provide nutrients to tumours, have been approved for treatment of renal cancer.  However, 30% of these patients are initially resistant to these drugs and 70% become resistant within months of treatment.

In the last five years, immunotherapy (ICIs) has shown some success in the treatment of renal cancer. Unfortunately, only 20-30% of patients initially respond to a combination therapy of ICI and TKIs but develop resistance within a few months for unknown reasons.

This study discusses comprehensively the nature of cells associated with renal cancer development, describes the mechanisms of therapy resistance and sheds light on the recent clinical trials. The review puts forward potential ways to overcome the resistance through rationally designed combination therapies. 

This is the first review that has consolidated the fundamental biological changes of renal cancer development, progression, information on therapy resistance, recent clinical trials, and discusses subsequent new treatments.

Read to full publication here.