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Decision-making in active surveillance in kidney cancer: current trends and future urine and tissue markers

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Abstract

Surveillance for small renal masses is a growing choice of management amongst physicians and patients. These decisions, however, can be difficult as patient factors and tumor factors may blur the line between continued surveillance and intervention. Currently, there are no biomarkers that are readily available to aid in the decision making for patients with known renal cell carcinoma; however, many show promise. We herein review the literature of the adjunct tools that are currently available for decision making in small renal masses, but also new potential biomarkers that can potentially be of use.

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References

  1. Siegel RL, Miller KD, Jemal A (2020) Cancer statistics, 2020. CA Cancer J Clin 70:7–30

    Article  PubMed  Google Scholar 

  2. Patel HD, Gupta M, Joice GA, Srivastava A, Alam R, Allaf ME, Pierorazio PM (2019) Clinical stage migration and survival for renal cell carcinoma in the United States. Eur Urol Oncol 2:343–348

    Article  PubMed  Google Scholar 

  3. Barrisford GW, Singer EA, Rosner IL, Linehan WM, Bratslavsky G (2011) Familial renal cancer: molecular genetics and surgical management. Int J Surg Oncol 2011:658767

    PubMed  PubMed Central  Google Scholar 

  4. Motzer RJ, Jonasch E, Michaelson MD et al (2019) NCCN guidelines insights: kidney cancer, version 2.2020. J Natl Compr Canc Netw 17:1278–1285

    Article  CAS  PubMed  Google Scholar 

  5. Campbell S, Uzzo RG, Allaf ME et al (2017) Renal mass and localized renal cancer: AUA guideline. J Urol 198:520–529

    Article  PubMed  Google Scholar 

  6. Modi PK, Farber NJ, Singer EA (2016) Precision oncology: identifying predictive biomarkers for the treatment of metastatic renal cell carcinoma. Transl Cancer Res 5:S76–S80

    Article  CAS  PubMed  Google Scholar 

  7. Clark DJ, Dhanasekaran SM, Petralia F et al (2019) Integrated proteogenomic characterization of clear cell renal cell carcinoma. Cell 179:964-983.e31

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Fisher R, Larkin J, Swanton C (2012) Inter and intratumour heterogeneity: a barrier to individualized medical therapy in renal cell carcinoma? Front Oncol 2:49

    PubMed  PubMed Central  Google Scholar 

  9. Pierorazio PM, Hyams ES, Mullins JK, Allaf ME (2012) Active surveillance for small renal masses. Rev Urol 14:13–19

    PubMed  PubMed Central  Google Scholar 

  10. Ray S, Cheaib JG, Pierorazio PM (2020) Active surveillance for small renal masses. Rev Urol 22:9–16

    PubMed  PubMed Central  Google Scholar 

  11. Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zincke H (2003) Solid renal tumors: an analysis of pathological features related to tumor size. J Urol 170:2217–2220

    Article  PubMed  Google Scholar 

  12. Bhindi B, Thompson RH, Lohse CM et al (2018) The probability of aggressive versus indolent histology based on renal tumor size: implications for surveillance and treatment. Eur Urol 74:489–497

    Article  PubMed  Google Scholar 

  13. Patel HD, Semerjian A, Gupta M, Pavlovich CP, Johnson MH, Gorin MA, Allaf ME, Pierorazio PM (2019) Surgical removal of renal tumors with low metastatic potential based on clinical radiographic size: a systematic review of the literature. Urol Oncol 37:519–524

    Article  PubMed  Google Scholar 

  14. Kato M, Suzuki T, Suzuki Y, Terasawa Y, Sasano H, Arai Y (2004) Natural history of small renal cell carcinoma: evaluation of growth rate, histological grade, cell proliferation and apoptosis. J Urol 172:863–866

    Article  PubMed  Google Scholar 

  15. Chawla SN, Crispen PL, Hanlon AL, Greenberg RE, Chen DYT, Uzzo RG (2006) The natural history of observed enhancing renal masses: meta-analysis and review of the world literature. J Urol 175:425–431

    Article  PubMed  Google Scholar 

  16. Kunkle DA, Egleston BL, Uzzo RG (2008) Excise, ablate or observe: the small renal mass dilemma—a meta-analysis and review. J Urol 179:1224–1227

    Google Scholar 

  17. McIntosh AG, Ristau BT, Ruth K et al (2018) Active surveillance for localized renal masses: tumor growth, delayed intervention rates, and >5-yr clinical outcomes. Eur Urol 74:157–164

    Article  PubMed  Google Scholar 

  18. Gupta M, Alam R, Patel HD et al (2019) Use of delayed intervention for small renal masses initially managed with active surveillance. Urol Oncol 37:18–25

    Article  PubMed  Google Scholar 

  19. Campbell SP, Tzortzakakis A, Javadi MS, Karlsson M, Solnes LB, Axelsson R, Allaf ME, Gorin MA, Rowe SP (2018) (99m)Tc-sestamibi SPECT/CT for the characterization of renal masses: a pictorial guide. Br J Radiol 91:20170526

    Article  PubMed  PubMed Central  Google Scholar 

  20. Levey AS, Eckardt K-U, Tsukamoto Y, Levin A, Coresh J, Rossert J, De Zeeuw D, Hostetter TH, Lameire N, Eknoyan G (2005) Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 67:2089–2100

    Article  PubMed  Google Scholar 

  21. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 130:461–470

    Article  CAS  PubMed  Google Scholar 

  22. Pinkham CA, Krause KJ (2009) Liver function tests and mortality in a cohort of life insurance applicants. J Insur Med 41:170–177

    PubMed  Google Scholar 

  23. Seaman E, Goluboff ET, Ross S, Sawczuk IS (1996) Association of radionuclide bone scan and serum alkaline phosphatase in patients with metastatic renal cell carcinoma. Urology 48:692–695

    Article  CAS  PubMed  Google Scholar 

  24. Patel SH, Meagher MF, Saito K et al (2019) Association of elevated C-reactive protein with oncologic outcomes in renal CELL carcinoma: a multicenter analysis. J Clin Oncol 37:596

    Article  Google Scholar 

  25. Hu Q, Gou Y, Sun C, Ding W, Xu K, Gu B, Xia G, Ding Q (2014) The prognostic value of C-reactive protein in renal cell carcinoma: a systematic review and meta-analysis. Urol Oncol 32:50.e1–8

    Article  CAS  Google Scholar 

  26. Fischer K, Theil G, Hoda R, Fornara P (2012) Serum amyloid A: a biomarker for renal cancer. Anticancer Res 32:1801–1804

    CAS  PubMed  Google Scholar 

  27. Patel HD, Iyoha E, Pierorazio PM, Sozio SM, Johnson MH, Sharma R, Bass EB, Allaf ME (2016) A Systematic review of research gaps in the evaluation and management of localized renal masses. Urology 98:14–20

    Article  PubMed  Google Scholar 

  28. Escudier B, Eisen T, Stadler WM et al (2009) Sorafenib for treatment of renal cell carcinoma: final efficacy and safety results of the phase III treatment approaches in renal cancer global evaluation trial. J Clin Oncol Off J Am Soc Clin Oncol 27:3312–3318

    Article  CAS  Google Scholar 

  29. Peña C, Lathia C, Shan M, Escudier B, Bukowski RM (2010) Biomarkers predicting outcome in patients with advanced renal cell carcinoma: results from sorafenib phase III Treatment Approaches in Renal Cancer Global Evaluation Trial. Clin cancer Res an Off J Am Assoc Cancer Res 16:4853–4863

    Article  CAS  Google Scholar 

  30. Voss MH, Chen D, Marker M, Hakimi AA, Lee C-H, Hsieh JJ, Knox JJ, Voi M, Motzer RJ (2016) Circulating biomarkers and outcome from a randomised phase II trial of sunitinib vs everolimus for patients with metastatic renal cell carcinoma. Br J Cancer 114:642–649

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Verkman AS, Hara-Chikuma M, Papadopoulos MC (2008) Aquaporins–new players in cancer biology. J Mol Med (Berl) 86:523–529

    Article  CAS  Google Scholar 

  32. Morrissey JJ, London AN, Luo J, Kharasch ED (2010) Urinary biomarkers for the early diagnosis of kidney cancer. Mayo Clin Proc 85:413–421

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Morrissey JJ, Mobley J, Figenshau RS, Vetter J, Bhayani S, Kharasch ED (2015) Urine aquaporin 1 and perilipin 2 differentiate renal carcinomas from other imaged renal masses and bladder and prostate cancer. Mayo Clin Proc 90:35–42

    Article  CAS  PubMed  Google Scholar 

  34. Song JB, Morrissey JJ, Mobley JM, Figenshau KG, Vetter JM, Bhayani SB, Kharasch ED, Figenshau RS (2019) Urinary aquaporin 1 and perilipin 2: Can these novel markers accurately characterize small renal masses and help guide patient management? Int J Urol Off J Japanese Urol Assoc 26:260–265

    CAS  Google Scholar 

  35. Gatto F, Maruzzo M, Magro C, Basso U, Nielsen J (2016) Prognostic value of plasma and urine glycosaminoglycan scores in clear cell renal cell carcinoma. Front Oncol 6:253

    Article  PubMed  PubMed Central  Google Scholar 

  36. Biles M, Cheaib J, Obeid C, Parikh R, Becker R, Alam R, Metcalf M, Patel H, Pierorazio P (2020) Urinary biomarker panel to differentiate benign renal masses from aggressive and indolent renal cell carcinoma. Can J Urol 27:PDA-6 10

  37. Linehan WM, Ricketts CJ (2013) The metabolic basis of kidney cancer. Semin Cancer Biol 23:46–55

    Article  CAS  PubMed  Google Scholar 

  38. Zheng H, Ji J, Zhao L, Chen M, Shi A, Pan L, Huang Y, Zhang H, Dong B, Gao H (2016) Prediction and diagnosis of renal cell carcinoma using nuclear magnetic resonance-based serum metabolomics and self-organizing maps. Oncotarget 7:59189–59198

    Article  PubMed  PubMed Central  Google Scholar 

  39. Catchpole G, Platzer A, Weikert C et al (2011) Metabolic profiling reveals key metabolic features of renal cell carcinoma. J Cell Mol Med 15:109–118

    Article  CAS  PubMed  Google Scholar 

  40. Falegan OS, Ball MW, Shaykhutdinov RA, Pieroraio PM, Farshidfar F, Vogel HJ, Allaf ME, Hyndman ME (2017) Urine and serum metabolomics analyses may distinguish between stages of renal cell carcinoma. Metabolites. https://doi.org/10.3390/metabo7010006

    Article  PubMed  PubMed Central  Google Scholar 

  41. Hakimi AA, Reznik E, Lee C-H et al (2016) An integrated metabolic atlas of clear cell renal cell carcinoma. Cancer Cell 29:104–116

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Ball MW, Gorin MA, Guner G, Pierorazio PM, Netto G, Paller CJ, Hammers HJ, Diaz LA, Allaf ME (2016) Circulating tumor DNA as a marker of therapeutic response in patients with renal cell carcinoma: a pilot study. Clin Genitourin Cancer 14:e515–e520

    Article  PubMed  PubMed Central  Google Scholar 

  43. Pal SK, Sonpavde G, Agarwal N et al (2017) Evolution of circulating tumor DNA profile from first-line to subsequent therapy in metastatic renal cell carcinoma. Eur Urol 72:557–564

    Article  CAS  PubMed  Google Scholar 

  44. Laganosky D, Lorentz C, Al-Qassab U et al (2017) Use of liquid biopsy for detection of renal cell carcinoma. J Clin Oncol 35:521

    Article  Google Scholar 

  45. Turajlic S, Xu H, Litchfield K et al (2018) Deterministic evolutionary trajectories influence primary tumor growth: TRACERx renal. Cell 173:595-610.e11

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. McGillivray PD, Ueno D, Pooli A et al (2020) Distinguishing benign renal tumors with an oncocytic gene expression (ONEX) classifier. Eur Urol. https://doi.org/10.1016/j.eururo.2020.09.017

    Article  PubMed  PubMed Central  Google Scholar 

  47. Di Meo A, Batruch I, Brown MD, Yang C, Finelli A, Jewett MA, Diamandis EP, Yousef GM (2020) Searching for prognostic biomarkers for small renal masses in the urinary proteome. Int J Cancer 146:2315–2325

    Article  PubMed  CAS  Google Scholar 

  48. Patel HD, Johnson MH, Pierorazio PM, Sozio SM, Sharma R, Iyoha E, Bass EB, Allaf ME (2016) Diagnostic accuracy and risks of biopsy in the diagnosis of a renal mass suspicious for localized renal cell carcinoma: systematic review of the literature. J Urol 195:1340–1347

    Article  PubMed  PubMed Central  Google Scholar 

  49. Marconi L, Dabestani S, Lam TB et al (2016) Systematic review and meta-analysis of diagnostic accuracy of percutaneous renal tumour biopsy. Eur Urol 69:660–673

    Article  PubMed  Google Scholar 

  50. Mitchell TJ, Turajlic S, Rowan A et al (2018) Timing the landmark events in the evolution of clear cell renal cell cancer: TRACERx renal. Cell 173:611-623.e17

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Silagy AW, Sanchez A, Manley BJ, Bensalah K, Bex A, Karam JA, Ljungberg B, Shuch B, Hakimi AA (2019) Harnessing the genomic landscape of the small renal mass to guide clinical management. Eur Urol Focus 5:949–957

    Article  PubMed  PubMed Central  Google Scholar 

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SHP: Protocol/project development, manuscript writing/editing. NS: Manuscript writing/editing. PP: Protocol/project development, Manuscript writing/editing.

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Correspondence to Phillip M. Pierorazio.

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Patel, S.H., Singla, N. & Pierorazio, P.M. Decision-making in active surveillance in kidney cancer: current trends and future urine and tissue markers. World J Urol 39, 2869–2874 (2021). https://doi.org/10.1007/s00345-021-03786-3

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  • DOI: https://doi.org/10.1007/s00345-021-03786-3

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