There has been significant progress made in the treatment of clear-cell renal cell carcinoma (RCC), with several targeted agents now approved. However, the vast majority of patients develop progressive disease within a year. Despite the clinical efficacy of targeted agents, significant toxicity hampers patient benefit, and <30% of patients with metastatic RCC survive >five years. Furthermore, insight into the biology of non-clear cell RCC subtypes has lagged behind clear-cell RCC, with few relevant targets identified. Currently, there is no established effective therapy for this diverse group of non-clear cell RCC subtypes. Therapeutic strategies using immune checkpoint antibodies are revolutionizing the treatment of many cancers including RCC, but at best 50% of patients with metastatic RCC respond to the combination of anti-PD-1 and anti-CTLA-4 antibodies. The long-term follow-up of patients with metastatic RCC treated with these novel immune approaches will be awaited to assess their curative potential.
My research focus in RCC is in the following areas:
Clinical and molecular characterization of non-clear cell RCC subtypes, particularly translocation RCC and renal medullary carcinoma Design and conduct of informative, biology-driven clinical trials for clear-cell and non-clear cell RCC Identification of circulating and tissue-based biomarkers of response to targeted agents and immune checkpoint antibodies in patients with clear-cell and non-clear cell RCC
The projects outlined above are currently being carried out in the context of several investigator-initiated, approved, and funded clinical and laboratory trials in metastatic clear-cell and non-clear cell RCC, on which I serve as principal investigator.