Dr. Pal on Molecular Signatures in Renal Cell Carcinoma

Sumanta Kumar Pal, MD, a medical oncologist at City of Hope, discusses the emergence of molecular signatures in patients with renal cell carcinoma (RCC).

PD-L1 can be used to guide a physician’s choice between a VEGF TKI or the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) for the treatment of a patient with metastatic RCC, although it’s not critical to the patient’s workup. In addition to PD-L1, molecular signatures have emerged as a potentially promising way to predict a patient’s response to therapy.

A lot of work has been done with bevacizumab (Avastin) and atezolizumab (Tecentriq), explains Pal. Based on this research, investigators were able to isolate an angiogenic signature that predicted response to TKI monotherapy compared with an immunotherapy signature that could result in a greater benefit with immunotherapy alone. These signatures are likely to have a huge impact on practice; however, they have to be prospectively validated first, concludes Pal.