Dr. Rini on Challenges With Biomarkers in RCC

Brian I. Rini, MD, professor of medicine, Cleveland Clinic, discusses challenges with biomarkers in renal cell carcinoma (RCC).

In most cases, biomarkers are suggestive not definitive, says Rini. Exceptions to this include HER2 in breast cancer, EGFR in non—small cell lung cancer, and KRAS in colorectal cancer. Ultimately, investigators working in the field are looking for a biomarker that can help guide treatment strategies. However, the field of kidney cancer has yet to find a marker with those capabilities. PD-L1 has been put forth as a potential biomarker for immunotherapy in RCC, however, a definitive correlation has not been demonstrated.

Clinical biomarker selection studies may be a way to unearth potential treatment strategies rather than looking for a tumor marker to do so, says Rini. One such trial is evaluating the use of nivolumab (Opdivo) monotherapy and ipilimumab (Yervoy) upon progression. To Rini, a clinical selection strategy could serve as a surrogate marker for biomarkers, which, at this point, have yet to be fully understood.