Researchers at the Francis Crick Institute and The Institute of Cancer Research, London have been awarded a $900,000 grant from the U.S. Department of Defense to develop tools to predict whether a kidney cancer will grow slowly or spread aggressively.
Increasingly, kidney tumours are diagnosed early, following tests for other reasons and often before the tumours cause any symptoms. Most of these tumours will grow slowly and will not spread around the body.
However, as it is not possible to predict which kidney tumours will be aggressive and potentially fatal, it is common for all or part of the affected kidney to be removed by surgery. This is a severe procedure that can cause complications later in life.
This new three-year grant will fund research aiming to help doctors predict the threat a kidney tumour poses to individual patients.
The research team will analyse samples of tumours from around 800 people with kidney cancer who have already had surgery to remove their tumour and from around 400 people who are having their kidney cancer monitored closely instead of surgery. In the monitoring – or active surveillance group – there is a unique opportunity to link features of the tumour directly to how it behaves in the patient over time.
They will test the tumour samples to look for genetic or molecular differences that could be used to predict how the disease will progress.
They will also look for differences in urine and blood samples, alongside CT scans, taken at regular intervals from the group whose tumours are being monitored. Using information from these samples, they hope to develop tests which could be used to predict when tumours will start to grow or spread.
The work could also lead to an increased understanding of cancer progression more broadly which could help the development of tools to monitor other tumours, for example prostate cancer.
Samra Turajlic, group leader of the Cancer Dynamics laboratory at the Crick and Team Leader of the Melanoma and Kidney Cancer team at The Institute of Cancer Research, London says: “By profiling these samples we hope to find a way to predict which patients have cancers that are ‘born to be bad’ - the tumours which are more likely to aggressively grow or spread.
“This would help identify patients who should have immediate surgery to remove their tumour, and those who should be actively monitored to see if their cancer progresses or not.
“This would allow doctors to personalise patient care, to counsel their patients about the competing risks of active surveillance versus immediate surgery, allowing them to make an informed choice about the most suitable way forward.
“As this study will follow tumours over time, it will also help us learn about the tumour evolution at the earliest stages of tumour development, including before a tumour spreads. This could lead us to a broader understanding of early detection and diagnosis of cancer, for example whether it is linked to certain types of molecular changes or a specific interaction with the immune system.”
This work is supported by the Office of the Assistant Secretary of Defense for Health Affairs through the FY21 Translational Research Partnership Award, Correlative Studies Option.