BRC: Biomarkers of Renal Cancer
Study Details
Study Description
Brief Summary
The aim of the present study is the identification, in liquid biopsies, of a new molecular panel able to discriminate renal cancer patients from controls, to discriminate patients with a malignant lesion from those with a benign mass, to determine aggressiveness of RCC, and to differentiate the most common histological subtypes of RCC (clear cell, papillary 1, papillary 2, and chromophobe).
This new molecular panel will be combined with clinical parameters to provide a screening test and to improve the accuracy and specificity of diagnosis, prognosis, and histological classification of renal cancer.
Condition or Disease | Intervention/Treatment | Phase |
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Detailed Description
The study is a translational one of the duration of 7 years and it is composed by a retrospective and a prospective phases.
- Retrospective phase:
Retrospective analysis of liquid and solid biopsies of patients diagnosed with a first episode of renal mass (of any histological subtype, such as clear cell RCC, type 1 and type 2 papillary RCC, chromophobe RCC, oncocytoma, and angiomyolipoma) and treated with radical or partial nephrectomy, in order to identify specific biomarkers for the screening, diagnosis, prognosis, and histological classification of renal cancer.
Patients with a first episode of renal mass whose plasma, urine, tumor and matched normal kidney tissue, and PBMC have been collected and stored in a biobank since 2011, will be stratified in different groups according to (i) the nature of renal mass (benign or malignant), (ii) the aggressiveness of renal cancer (indolent kidney cancer or aggressive kidney cancer), and (iii) the presence or absence of clinical metastasis; (iv) specific histotype of renal mass (e.g., clear cell RCC, type 1 and type 2 papillary RCC, chromophobe RCC, oncocytoma, and angiomyolipoma).
The same type of biological samples mentioned above from patients affected by urological functional diseases (such as kidney stones or benign prostate hypertrophy) have been collected and stored in a biobank between 2014 and 2018 and will be also analyzed as controls.
The samples will be fractionated and subjected to different analysis, such as the detection of nucleic acids (DNA and RNA), and proteins. These macromolecules will be purified and analyzed by employing methods such as real time PCR, microarrays, sequencing, ELISA assays, or mass spectrometry.
- Prospective phase and multicenter trial:
Validation of the biomarker panel in a wider cohort of patients affected by renal mass.
An ideal tumor marker is easily detected and dosed, is sensitive and specific and its clinical significance is easy to deduce. To confirm the results obtained in archived samples and validate a panel of biomarkers to be translate in the clinical practice, it will be collected whole blood, plasma and urine samples from a validation cohort of patients.
It will enrolled patients affected by renal masses (e.g., clear cell RCC, type 1 and type 2 papillary RCC, chromophobe RCC, oncocytoma, and angiomyolipoma), who will undergo radical or partial nephrectomy, and controls (patients affected by urological functional diseases, such as kidney stones or benign prostate hypertrophy) with a ratio of 2:1 in all centers included.
For each patients, clinical data will be collected, creating a dataset with the same variables used in the discovery cohort.
The aim of this prospective phase will be to confirm that the identified molecules can improve the management of patients with RCC at all the stages of clinical decision-making, in particular for the screening, diagnosis, prognosis, and histological classification of RCC.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Renal-mass patients Patients diagnosed with a first episode of renal mass attending the urology department. |
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Control subjects Patients affected by urological functional diseases or living kidney donor. |
Outcome Measures
Primary Outcome Measures
- Screening [Analysis of biological samples collected before surgery]
Identification of biomarkers able to predict the presence of a renal mass, defined as a mass either benign or malignant recorded at axial imaging examination (either CT or MRI).
- Diagnosis [Analysis of biological samples collected before surgery]
Identification of biomarkers able to predict the presence of a Renal Cell Carcinoma, defined as a renal malignancy
- Prognosis [Analysis of biological samples collected before surgery]
Identification of biomarkers able to predict the presence of an aggressive Renal Cell Carcinoma
Eligibility Criteria
Criteria
Inclusion Criteria for renal-mass patients:
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Men and women over 18 years of age
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Diagnosis of first episode of renal mass
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Caucasian race
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Signed, informed consent
Exclusion Criteria renal-mass patients:
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Any other concomitant cancer or history of active cancer in the last 5 years
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Oncological genetic syndrome
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Previous history of renal tumour
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Urothelial cancer
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End-stage renal disease on hemodialysis
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Bilateral renal cell carcinoma
Inclusion Criteria for control subjects:
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Men and women over 18 years of age
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Caucasian race
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Living kidney donor or patient with urological functional diseases (e.g. kidney stones, benign prostate hypertrophy, etc..)
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Signed, informed consent
Exclusion criteria for control subjects:
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History of active cancer in the last 5 years
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Oncological genetic syndrome
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End-stage renal disease on hemodialysis or peritoneal dialysis
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Azienda Ospedaliera Universitaria Careggi | Firenze | Italy | 50139 | |
2 | IRCCS San Raffaele | Milano | Italy | 20132 | |
3 | Azienda Ospedaliera Universitaria San Luigi Gonzaga | Orbassano | Italy | 10043 | |
4 | FundaciĆ³ Puigvert | Barcelona | Spain | 08025 |
Sponsors and Collaborators
- Biorek S.R.L.
Investigators
- Principal Investigator: Francesco Montorsi, IRCCS San Raffaele
Study Documents (Full-Text)
None provided.More Information
Publications
- Capitanio U, Terrone C, Antonelli A, Minervini A, Volpe A, Furlan M, Matloob R, Regis F, Fiori C, Porpiglia F, Di Trapani E, Zacchero M, Serni S, Salonia A, Carini M, Simeone C, Montorsi F, Bertini R. Nephron-sparing techniques independently decrease the risk of cardiovascular events relative to radical nephrectomy in patients with a T1a-T1b renal mass and normal preoperative renal function. Eur Urol. 2015 Apr;67(4):683-9. doi: 10.1016/j.eururo.2014.09.027. Epub 2014 Oct 3.
- Chanudet E, Wozniak MB, Bouaoun L, Byrnes G, Mukeriya A, Zaridze D, Brennan P, Muller DC, Scelo G. Large-scale genome-wide screening of circulating microRNAs in clear cell renal cell carcinoma reveals specific signatures in late-stage disease. Int J Cancer. 2017 Nov 1;141(9):1730-1740. doi: 10.1002/ijc.30845. Epub 2017 Jul 7.
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- Fedorko M, Stanik M, Iliev R, Redova-Lojova M, Machackova T, Svoboda M, Pacik D, Dolezel J, Slaby O. Combination of MiR-378 and MiR-210 Serum Levels Enables Sensitive Detection of Renal Cell Carcinoma. Int J Mol Sci. 2015 Sep 29;16(10):23382-9. doi: 10.3390/ijms161023382.
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- Hauser S, Wulfken LM, Holdenrieder S, Moritz R, Ohlmann CH, Jung V, Becker F, Herrmann E, Walgenbach-Brunagel G, von Ruecker A, Muller SC, Ellinger J. Analysis of serum microRNAs (miR-26a-2*, miR-191, miR-337-3p and miR-378) as potential biomarkers in renal cell carcinoma. Cancer Epidemiol. 2012 Aug;36(4):391-4. doi: 10.1016/j.canep.2012.04.001. Epub 2012 Apr 26.
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- Iwamoto H, Kanda Y, Sejima T, Osaki M, Okada F, Takenaka A. Serum miR-210 as a potential biomarker of early clear cell renal cell carcinoma. Int J Oncol. 2014 Jan;44(1):53-8. doi: 10.3892/ijo.2013.2169. Epub 2013 Nov 7.
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- Linehan WM, Pinto PA, Srinivasan R, Merino M, Choyke P, Choyke L, Coleman J, Toro J, Glenn G, Vocke C, Zbar B, Schmidt LS, Bottaro D, Neckers L. Identification of the genes for kidney cancer: opportunity for disease-specific targeted therapeutics. Clin Cancer Res. 2007 Jan 15;13(2 Pt 2):671s-679s. doi: 10.1158/1078-0432.CCR-06-1870.
- Ljungberg B, Bensalah K, Canfield S, Dabestani S, Hofmann F, Hora M, Kuczyk MA, Lam T, Marconi L, Merseburger AS, Mulders P, Powles T, Staehler M, Volpe A, Bex A. EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol. 2015 May;67(5):913-24. doi: 10.1016/j.eururo.2015.01.005. Epub 2015 Jan 21.
- Morrissey JJ, Mellnick VM, Luo J, Siegel MJ, Figenshau RS, Bhayani S, Kharasch ED. Evaluation of Urine Aquaporin-1 and Perilipin-2 Concentrations as Biomarkers to Screen for Renal Cell Carcinoma: A Prospective Cohort Study. JAMA Oncol. 2015 May;1(2):204-12. doi: 10.1001/jamaoncol.2015.0213.
- Morrissey JJ, Mobley J, Figenshau RS, Vetter J, Bhayani S, Kharasch ED. Urine aquaporin 1 and perilipin 2 differentiate renal carcinomas from other imaged renal masses and bladder and prostate cancer. Mayo Clin Proc. 2015 Jan;90(1):35-42. doi: 10.1016/j.mayocp.2014.10.005.
- Morrissey JJ, Mobley J, Song J, Vetter J, Luo J, Bhayani S, Figenshau RS, Kharasch ED. Urinary concentrations of aquaporin-1 and perilipin-2 in patients with renal cell carcinoma correlate with tumor size and stage but not grade. Urology. 2014 Jan;83(1):256.e9-14. doi: 10.1016/j.urology.2013.09.026. Epub 2013 Nov 13.
- Pantuck AJ, Zisman A, Belldegrun AS. The changing natural history of renal cell carcinoma. J Urol. 2001 Nov;166(5):1611-23.
- Redova M, Poprach A, Nekvindova J, Iliev R, Radova L, Lakomy R, Svoboda M, Vyzula R, Slaby O. Circulating miR-378 and miR-451 in serum are potential biomarkers for renal cell carcinoma. J Transl Med. 2012 Mar 22;10:55. doi: 10.1186/1479-5876-10-55.
- Richard PO, Jewett MA, Bhatt JR, Kachura JR, Evans AJ, Zlotta AR, Hermanns T, Juvet T, Finelli A. Renal Tumor Biopsy for Small Renal Masses: A Single-center 13-year Experience. Eur Urol. 2015 Dec;68(6):1007-13. doi: 10.1016/j.eururo.2015.04.004. Epub 2015 Apr 18.
- Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012 Jan-Feb;62(1):10-29. doi: 10.3322/caac.20138. Epub 2012 Jan 4.
- Teixeira AL, Ferreira M, Silva J, Gomes M, Dias F, Santos JI, Mauricio J, Lobo F, Medeiros R. Higher circulating expression levels of miR-221 associated with poor overall survival in renal cell carcinoma patients. Tumour Biol. 2014 May;35(5):4057-66. doi: 10.1007/s13277-013-1531-3. Epub 2013 Dec 31.
- Thompson RH, Ordonez MA, Iasonos A, Secin FP, Guillonneau B, Russo P, Touijer K. Renal cell carcinoma in young and old patients--is there a difference? J Urol. 2008 Oct;180(4):1262-6; discussion 1266. doi: 10.1016/j.juro.2008.06.037. Epub 2008 Aug 15.
- Wang C, Hu J, Lu M, Gu H, Zhou X, Chen X, Zen K, Zhang CY, Zhang T, Ge J, Wang J, Zhang C. A panel of five serum miRNAs as a potential diagnostic tool for early-stage renal cell carcinoma. Sci Rep. 2015 Jan 5;5:7610. doi: 10.1038/srep07610.
- Wulfken LM, Moritz R, Ohlmann C, Holdenrieder S, Jung V, Becker F, Herrmann E, Walgenbach-Brunagel G, von Ruecker A, Muller SC, Ellinger J. MicroRNAs in renal cell carcinoma: diagnostic implications of serum miR-1233 levels. PLoS One. 2011;6(9):e25787. doi: 10.1371/journal.pone.0025787. Epub 2011 Sep 30.
- BRC