At Global Voices in Renal Oncology (VIRO) 2025, Dr. Panagiotis J Vlachostergios, Assistant Professor of Clinical Medicine at Weill Cornell Medical College, delivered a talk on “Biomarkers for adjuvant therapy benefit in RCC.”
He emphasized that while PD-L1 has been widely investigated in RCC trials, its predictive value remains inconsistent. In most adjuvant trials, PD-L1 expression was common and did not guide therapy, although in certain trials with low PD-L1 prevalence, small signals of immunotherapy benefit were observed.
Dr. Vlachostergios also discussed the role of genomic markers, including PBRM1 and genes within the chromatin remodeling family, which have diagnostic or prognostic significance but limited predictive value for adjuvant therapy. Gene expression signatures, such as angiogenesis or T-cell effector signatures, can categorize RCC into molecular subtypes with potential prognostic implications and differential response patterns, although their predictive power for treatment benefit is still under investigation.
He noted that histological features, including sarcomatoid differentiation, are associated with poor prognosis and may influence treatment considerations. Overall, while several biomarkers show promise in understanding RCC biology and prognosis, no single biomarker is yet reliable enough to guide adjuvant therapy decisions, highlighting the need for continued research and molecular stratification in clinical trials.
Panagiotis J. Vlachostergios at VIRO 2025
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