Wenxin Xu: KIM-1 as a Predictive Biomarker for Adjuvant Immunotherapy in Kidney Cancer
Wenxin (Vincent) Xu, Assistant Professor of Medicine at Harvard Medical School and a Medical Oncologist at Dana-Farber Cancer Institute, shared a post on X:
“Now out in Annals of Oncology!
In patients with kidney cancer, a blood test for KIM-1 is prognostic and predictive for adjuvant immunotherapy.
Adjuvant pembrolizumab is now standard of care in kidney cancer, but there are no blood tests to help select patients. Prior studies have shown that circulating KIM-1 is associated with recurrence risk after nephrectomy.
However, can it predict who benefits from immunotherapy?
IMmotion010 was a phase 3 trial comparing adjuvant atezolizumab vs placebo in kidney cancer.
We measured KIM-1 levels at baseline and on-treatment using an affinity-based proteomics assay and a confirmatory electrochemiluminescence assay.
Among 2,925 circulating proteins, KIM-1 was the most enriched among patients who eventually had cancer recurrence vs those who did not.
High KIM-1 after surgery was associated with worse disease-free survival (hazard ratio 1.68, 95% CI 1.35-2.09).
Adjuvant atezolizumab improved disease-free survival among patients with high KIM-1 at baseline (hazard ratio 0.72, 95% CI 0.52-0.99), but not among those with low KIM-1. Increasing KIM-1 during follow-up was associated with recurrence.
Within the KIM-1 high subgroup, longer DFS following atezolizumab treatment was associated with increased baseline expression of T effector and Th1 signatures, while shorter DFS was associated with baseline expression of matrix remodeling genes and protumor cytokines.
These results show that circulating KIM-1 is a biomarker for residual disease. Prospective trials are needed to validate biomarker driven adjuvant therapy as a potential paradigm in kidney cancer!”
Title: Circulating kidney injury molecule-1 (KIM-1) and association with outcome to adjuvant immunotherapy in renal cell carcinoma
Journal: Annals of Oncology
Authors: B.I. Rini, L. Albiges, X. Tang, H. Koeppen, A. Bex, C. Suárez, R. Uzzo, H. Hamidi, Z.J. Assaf, S. Dubey, E.T. Goluboff, C. Carter, S.K. Pal, R. Banchereau, W. Xu, M.A. Huseni
Read the full article.
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