Abstract 1196
Background
There is currently no circulating biomarker for renal cell carcinoma (RCC). The use of adjuvant sunitinib for RCC after nephrectomy is controversial, and a biomarker could help to select the patients at highest risk for recurrence. Kidney injury molecule-1 (KIM-1) is overexpressed in RCC and its ectodomain can be detected in circulating plasma. We therefore investigated whether KIM-1 is associated with worse outcomes in patients with localized RCC after nephrectomy.
Methods
In the ECOG-ACRIN 2805 (ASSURE) trial, 1943 patients with resected high-risk RCC were randomized 1:1:1 to sunitinib, sorafenib, or placebo. Post-nephrectomy baseline samples from 182 randomly selected patients (9.4% of the study population) was available for this post-hoc biomarker analysis. Samples were analyzed using a previously validated microbead-based assay. Kaplan-Meier and Cox proportional hazards models were used to test for association between circulating KIM-1 and disease free survival (DFS) as well as overall survival (OS). ROC analysis was performed to evaluate test characteristics for KIM-1 in predicting RCC recurrence within 6 months after nephrectomy.
Results
Higher KIM-1 levels were associated with worse DFS and OS after nephrectomy. This association remained independently significant after controlling for pathologic stage, sarcomatoid features, and Fuhrman grade (DFS: HR 1.20 per log increase in KIM-1, 95% CI 1.09-1.33, p < 0.001; OS: HR 1.27 per log increase in KIM-1, 95% CI 1.11-1.45, p < 0.001). These associations were independent of treatment arm. In Kaplan-Meier analysis using KIM-1 quartiles, higher quartiles of KIM-1 were associated with worse DFS and OS (log-rank p = 0.02 for both). Post-nephrectomy KIM-1 was a prognostic marker for disease recurrence within 6 months after nephrectomy (AUC 0.85).
Conclusions
Elevated plasma KIM-1 is associated with worse DFS and OS in patients with resected RCC, and therefore has potential as an adjuvant biomarker. Analysis of larger cohorts to confirm this association is underway.
Clinical trial identification
NCT00326898.
Editorial acknowledgement
Legal entity responsible for the study
ECOG-ACRIN Cancer Research Group (Peter J. O’Dwyer, MD and Mitchell D. Schnall, MD, PhD, Group Co-Chairs).
Funding
National Cancer Institute of the National Institutes of Health under the following award numbers: CA180820, CA180794, CA180867, CA189859.
Disclosure
K.T. Flaherty: Officer / Board of Directors: Loxo Oncology; Officer / Board of Directors: Clovis Oncology; Officer / Board of Directors: Strata Oncology; Officer / Board of Directors: Vivid Biosciences; Advisory / Consultancy, Corporate Advisory Board: X4 Pharmaceuticals; Advisory / Consultancy, Corporate Advisory Board: PIC Therapeutics; Advisory / Consultancy: Sanofi; Advisory / Consultancy: Amgen; Advisory / Consultancy: Asana; Advisory / Consultancy: Adaptimmune; Advisory / Consultancy: Fount; Advisory / Consultancy: Aeglea; Advisory / Consultancy: Array BioPharma; Advisory / Consultancy: Shattuck Labs; Advisory / Consultancy: Arch Oncology; Advisory / Consultancy: Tolero; Advisory / Consultancy: Apricity; Advisory / Consultancy: Oncoceutics; Advisory / Consultancy: Fog Pharma; Advisory / Consultancy, Checkmate, Boston Biomedical, Pierre Fabre, Cell Medica, and Debiopharm.: Others; Advisory / Consultancy: Neon Therapeutics; Advisory / Consultancy: Tvardi; Advisory / Consultancy: Novartis; Advisory / Consultancy: Genentech; Advisory / Consultancy: BMS; Advisory / Consultancy: Merck; Advisory / Consultancy: Takeda; Advisory / Consultancy: Verastem. V. Sabbisetti: Non-remunerated activity/ies, Patents on blood KIM-1 is a diagnostic, prognostic and predictive biomarker of RCC: Other. All other authors have declared no conflicts of interest.
Resources from the same session
2171 - CCND1 Amplification Contributes to Immunosuppression in Head and Neck Squamous Cell Carcinoma and the Association with a Poor Response to Immune Checkpoint Inhibitors
Presenter: Chloe Huang
Session: Poster Display session 3
Resources:
Abstract
2624 - Efficacy of PD-1/PD-L1 inhibitors in the treatment of non-small cell lung cancer patients with sensitive genes mutation
Presenter: Hui-Juan Cui
Session: Poster Display session 3
Resources:
Abstract
3494 - Neutrophil to Lymphocyte Ratio (NLR) kinetics as predictors of outcomes in metastatic renal cell carcinoma (mRCC) and non-small cell lung cancer (NSCLC) patients treated with nivolumab (N).
Presenter: Audrey Simonaggio
Session: Poster Display session 3
Resources:
Abstract
3964 - Predictive markers of checkpoint inhibitor activity in adult metastatic solid tumours
Presenter: Alexandra Pender
Session: Poster Display session 3
Resources:
Abstract
3041 - Blood-based TMB (bTMB) correlates with tissue-based TMB (tTMB) in a multi-cancer Phase I IO Cohort
Presenter: Daniel Araujo
Session: Poster Display session 3
Resources:
Abstract
3910 - Analysis of Molecular Profile Complexities for Immunotherapy Decision Support
Presenter: Robert Dóczi
Session: Poster Display session 3
Resources:
Abstract
4836 - The Role of Tumor Neoantigens in the Differential Response to Immunotherapy (IO) in EGFR and BRAF Mutated Lung Cancers - Quantity or Quality?
Presenter: Katrina Case
Session: Poster Display session 3
Resources:
Abstract
1929 - Impact of previous corticosteroid (CS) exposure on efficacy of Programmed Cell Death-(Ligand) 1 blockade in patients with advanced Non-Small-Cell Lung Cancer (NSCLC): a single Center retrospective analysis
Presenter: Fabrizio Nelli
Session: Poster Display session 3
Resources:
Abstract
2601 - Comparison 18F-FDG-PET/CT criteria for prediction of therapy response and clinical outcome in patients with metastatic melanoma treated with Ipilimumab and PD-1 inhibitors
Presenter: Sabrina Vari
Session: Poster Display session 3
Resources:
Abstract
3628 - Predictive model for survival in advanced non-small-cell lung cancer (NSCLC) treated with frontline pembrolizumab
Presenter: Xabier Mielgo Rubio
Session: Poster Display session 3
Resources:
Abstract