Is Plasma KIM-1 Linked to Recurrence Risk After Nephrectomy?
Posted: Thursday, April 29, 2021
Rupal S. Bhatt, MD, PhD, of Beth Israel Deaconess Medical Center, Boston, and colleagues performed a study to determine whether plasma kidney injury molecule-1 (KIM-1) is associated with overall survival and disease-free survival after nephrectomy for localized renal cell carcinoma. Using data from previous phases of research, the researchers discovered a potential association between these factors, suggesting that KIM-1 may prove to be a future biomarker for microscopic residual disease. Their updated findings were published in Clinical Cancer Research.
Investigators of the phase III ASSURE trial analyzed plasma samples of 418 patients with high-grade, pathologic stage T1b or higher renal cell carcinoma who underwent total nephrectomy. Patients were randomly assigned 1:1:1 to receive adjuvant sorafenib, sunitinib, or a placebo over 54 weeks.
Clear cell histology was observed in 79% of participants; 47% had very high–risk disease, 19% had Fuhrman grade 4 disease, and 11% displayed sarcomatoid features. After nephrectomy and before study treatment, the median KIM-1 level was 76 pg/mL. No significant associations between postnephrectomy KIM-1 levels and age, sex, or Eastern Cooperative Oncology Group performance status were observed. Furthermore, there seemed to no connection with sarcomatoid features, staging, Fuhrman grade, or histologic subtype, suggesting that postnephrectomy KIM-1 may be independent of clinicopathologic predictors of relapse.
KIM-1 was associated with poor disease-free survival (P = .004), the investigators reported, as 199 disease-free survival events and 128 deaths were observed; however, this instance might be driven by disease-free survival events within 2 years after nephrectomy. Additionally, a strong association was noted between KIM-1 and disease-free survival among patients with pathologic nodal involvement (P = .0086). The investigators also observed a trend toward worse overall survival for individuals with higher KIM-1 levels at baseline, but it was not statistically significant (P = .056).
Disclosure: For full disclosures of the study authors, visit clincancerres.aacrjournals.org.