Circulating Tumor Cells for the Management of Renal Cell Carcinoma

Renal cell carcinoma is a highly malignant cancer that would benefit from non-invasive innovative markers providing early diagnosis and recurrence detection. Circulating tumor cells are a particularly promising marker of tumor invasion that could be used to improve the management of patients with RCC. However, the extensive genetic and immunophenotypic heterogeneity of cells from RCC and their trend to transition to the mesenchymal phenotype when they circulate in blood constitute a challenge for their sensitive and specific detection. This review analyzes published studies targeting CTC in patients with RCC, in the context of the biological, pathological, and molecular complexity of this particular cancer. Although further analytical and clinical studies are needed to pinpoint the most suitable approach for highly sensitive CTC detection in RCC patients, it is clear that this field can bring a relevant guide to clinicians and help to RCC patients. Furthermore, as described, a particular subtype of RCC—the ccRCC—can be used as a model to study the relationship between cytomorphological and genetic cellular markers of malignancy, an important issue for the study of CTC from any type of solid cancer.

Download Full-text

Prognostic Role of Circulating Tumor Cells ( CTCS ) in Metastatic Renal Cell Carcinoma: A Large, Multicenter Prospective Trial

The Oncologist ◽

10.1002/onco.13842 ◽

2021 ◽

Author(s):

Umberto Basso ◽

Antonella Facchinetti ◽

Elisabetta Rossi ◽

Marco Maruzzo ◽

Vincenza Conteduca ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Tumor Cells ◽

Circulating Tumor Cells ◽

Metastatic Renal Cell Carcinoma ◽

Renal Cell ◽

Prospective Trial ◽

Prognostic Role

Download Full-text

Analysis of Single Circulating Tumor Cells in Renal Cell Carcinoma Reveals Phenotypic Heterogeneity and Genomic Alterations Related to Progression

International Journal of Molecular Sciences ◽

10.3390/ijms21041475 ◽

2020 ◽

Vol 21 (4) ◽

pp. 1475

Author(s):

Vera Cappelletti ◽

Elena Verzoni ◽

Raffaele Ratta ◽

Marta Vismara ◽

Marco Silvestri ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Tumor Cells ◽

Circulating Tumor Cells ◽

Renal Cell ◽

Progression Free Survival ◽

Response Prediction ◽

Surface Proteins ◽

Cell Recovery ◽

Epithelial Cell Surface

Circulating tumor cells (CTCs) are promising biomarkers for prognosis, therapeutic response prediction, and treatment monitoring in cancer patients. Despite its epithelial origin, renal cell carcinoma (RCC) shows low expression of epithelial markers hindering CTC-enrichment approaches exploiting epithelial cell surface proteins. In 21 blood samples serially collected from 10 patients with metastatic RCC entering the TARIBO trial, we overcame this limitation using the marker-independent Parsortix™ approach for CTC-enrichment coupled with positive and negative selection with the DEPArray™ with single cell recovery and analysis for copy number alterations (CNA) by next generation sequencing NGS. Two CTC subpopulations were identified: epithelial CTC (eCTC) and non-conventional CTC (ncCTC) lacking epithelial and leukocyte markers. With a threshold ≥1CTC/10 mL of blood, the positivity rates were 28% for eCTC, 62% for ncCTCs, and 71% considering both CTC types. In two patients with detectable eCTCs at baseline, progression free survival was less than 5 months. In an index case, hierarchical structure by translational oncology (TRONCO) identified three clones among 14 CTCs collected at progression and at baseline, each containing cells with a 9p21.3loss, a well-known metastasis driving subclonal alteration. CTCs detection in RCC can be increased by marker-independent approaches, and CTC molecular characterization can allow detection of subclonal events possibly related to tumor progression.

Download Full-text