Dana-Farber Cancer Institute's D. Wenxin (Vincent) Xu shares research suggesting a blood test measuring levels of the KIM-1 biomarker could help assess the burden of disease in advanced kidney cancer and predict outcomes during first-line treatment.
In kidney cancer, we currently don't have any blood tests that can tell us how much cancer someone has. In a previous study, we had shown that among patients being treated with immunotherapy, a blood-based biomarker called CIM1, which is a protein, at baseline tells us how high risk a patient is and that early changes in CIM one after immunotherapy treatment can tell us if someone is likely to have long term response and great overall survival. In this trial, we validate these findings in an independent phase 3 randomized trial. Cosmic 313 was a randomized trial treating patients with kidney cancer, and patients were randomized to receive either standard of care immunotherapy with epilimumab plus navalimab, or that immunotherapy with the addition of Cabozantinib. In this trial, we took blood samples from patients at pre-treatment baseline and after each cycle of treatment. We found that the Kim one blood test was associated at high levels with worse outcomes at pre-treatment baseline, but what was even more exciting to me was that we found that early changes in Kim1 on treatment, a decrease in the level of this blood test, even at 3 weeks, was associated with really great long term responses to immunotherapy and longer survival for patients. And so when we looked at the levels of this biomarker over time. Decrease over time continued to show association with outcomes after each cycle. My takeaway from this data is that this blood test might be useful in helping to guide the treatment of patients with kidney cancer. Patients with a great CIM1 response, even at 3 weeks after treatment, might expect to have an excellent outcome. But patients who don't have this promising response early on might benefit from adjustment of their treatment strategy to get the best possible results.
