A biomarker of kidney disease may help predict clear cell kidney cancer – the most common form of kidney cancer – years before clinical diagnosis, according to a new study published in the journal Clinical Cancer Research.
Kidney-injury-molecule-1 (KIM-1) can be detected in the urine and blood and is generally present at low levels in healthy individuals. Prior research by leaders at Brigham and Women’s Hospital has shown that KIM-1 is an important and highly predictive marker for kidney injury.
In the new study researchers explore whether a blood test can detect higher concentrations of KIM-1 in patients who will go on to develop kidney cancer up to five years later. Their results show that KIM-1 substantially helped distinguish between those who went on to develop kidney cancer from those who did not.
Venkata Sabbisetti, the study’s lead author, said: ‘Early detection of kidney cancer can be lifesaving. We can cure kidney cancer when we detect it at an early stage, but patients with advanced kidney cancer have a very high death rate. However, kidney cancer is asymptomatic and many patients present with advanced kidney cancer at the time of diagnosis. Our results suggest that with further refinement, KIM-1 has the potential to identify patients with early, curable kidney cancer.’
Sabbisetti and colleagues measured KIM-1 concentrations in samples from patients enrolled in the European Prospective Investigation into Cancer and nutrition (EPIC). The team compared KIM-1 levels from 190 participants who went on to develop RCC within the next five years to 190 matched participants (same age, body mass index, smoking status, etc.) who remained healthy. In samples with detectable levels of KIM-1, the average concentration was double in those who would develop kidney cancer.
The team reported that adding KIM-1 to a model for predicting kidney cancer risk approximately doubled the accuracy of that model. KIM-1 was substantially more sensitive for kidney cancer detection than prostate specific antigen is for prostate cancer. However, given how much rarer RCC is, the researchers noted that KIM-1 should be measured along with another kidney disease specific markers to be useful for early detection in the general population.