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Activity of Immune System Could Predict Recurrence of Localized Kidney Cancer

August 27, 2019

Dr. Pooja Ghatalia and her colleagues wanted to investigate immune cells that existed in the kidney tumor microenvironment in order to better understand how these cells might predict response to immunotherapy in patients who have had surgery for localized, nonmetastatic disease. Increased presence of certain immune T cells was associated with a lower risk for disease recurrence. Dr. Pooja Ghatalia and her colleagues wanted to investigate immune cells that existed in the kidney tumor microenvironment in order to better understand how these cells might predict response to immunotherapy in patients who have had surgery for localized, nonmetastatic disease. Increased presence of certain immune T cells was associated with a lower risk for disease recurrence.

PHILADELPHIA (August 27, 2019) – The presence or absence of certain immune cells in patients with localized kidney cancer was associated with the likelihood that the tumor would return after surgical removal, according to a new study from researchers at Fox Chase Cancer Center.

Pooja Ghatalia, MD, and colleagues recently found that the increased presence of certain immune T cells was associated with a lower risk for disease recurrence. A lower presence of these T cells was associated with an increased risk for recurrence.

“Immunotherapy is currently approved alone or in combination with other treatments in patients with metastatic kidney cancer,” said Ghatalia, an assistant professor in the Department of Hematology/Oncology at Fox Chase. “However, there is currently no role for immunotherapy in patients who have had surgery for localized, nonmetastatic disease.”

Ghatalia and her colleagues wanted to investigate immune cells that existed in the kidney tumor microenvironment in order to better understand how these cells might predict response to immunotherapy in this setting.

Sections of tumor were taken from 190 patients with kidney cancer treated at the University of Alabama at Birmingham (UAB) who underwent surgical removal of their tumor. Ghatalia’s team looked at each section under a microscope and quantified the immune cells present in the sample. They found that the presence of more immune infiltrates correlated with greater disease recurrence. This finding was confirmed in an additional 198 samples taken from patients at Fox Chase.

Next, Ghatalia and colleagues assessed gene expression in the samples from UAB that had the highest rates of immune cell infiltration. Lower presence of T cells, lower presence of adaptive immune cells, and a greater presence of neutrophils were all significantly associated with a higher rate of recurrence. These results were confirmed in an additional group of samples taken from the Cancer Genome Atlas.

“This finding is consistent to what is found in patients with metastatic disease,” Ghatalia said. “What this means is that the immune infiltrates that we see in patients with localized disease could potentially be taken advantage of.” There are ongoing clinical trials testing immunotherapy in localized disease both prior to and after surgery to remove the tumor.

“The fact that these immune cells are abundantly present in patients who have localized kidney cancer suggests that using immunotherapy when patients’ kidney tumors are still in the body may help by taking advantage of the T cell located within the immune microenvironment and potentially prevent recurrence,” Ghatalia said.

Their study, “Prognostic Impact of Immune Gene Expression Signature and Tumor Infiltrating Immune Cells in Localized Clear Cell Renal Cell Carcinoma,” was published in the Journal of ImmunoTherapy of Cancer.

The study was supported by funding from the Kidney Cancer Association Young Investigator Grant and Bucks Board of Associates funding.

       

The Hospital of Fox Chase Cancer Center and its affiliates (collectively “Fox Chase Cancer Center”), a member of the Temple University Health System, is one of the leading cancer research and treatment centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence five consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship and community outreach. It is the policy of Fox Chase Cancer Center that there shall be no exclusion from, or participation in, and no one denied the benefits of, the delivery of quality medical care on the basis of race, ethnicity, religion, sexual orientation, gender, gender identity/expression, disability, age, ancestry, color, national origin, physical ability, level of education, or source of payment.
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