Showing posts with label kidney. Show all posts
Showing posts with label kidney. Show all posts

Sunday, June 12, 2011

Kidney cancer discovery could expand treatment options

ScienceDaily (June 1, 2011) — Oregon Health & Science University Knight Cancer Institute researchers uncovered a gene that may be the key to helping kidney cancer patients who don't respond to current therapies. This discovery could also provide a toolkit to identify patients who are most likely to benefit from drugs that block this gene from causing cancer cells to grow.

See Also:Health & MedicineCancerKidney DiseaseBrain TumorLung CancerColon CancerBreast CancerReferenceMetastasisNanomedicineClinical trialRenal cell carcinoma

The OHSU study, published in the June 1 edition of Science Translational Medicine, identified a gene called Src that helps certain kidney cancers grow. Discovering that Src plays a role in kidney cancer could help in delivering more effective, individualized treatments to patients, said George Thomas, M.D., the study's senior author and a surgical pathologist at the OHSU Knight Cancer Institute.

The next step, Thomas said, is initiating clinical trials to test how these tumors respond to drugs already available and approved by the FDA.

There are many implications for the Src findings. Last year alone, kidney cancer accounted for about 58,000 new cases of cancer and 13,000 deaths in the United States. More than a quarter of these patients have metastatic disease when their cancer is discovered, and patients who are treated with surgery frequently relapse.

Currently, treatment of kidney cancer is primarily focused on blocking the formation of new blood vessels. While this strategy has been successful in the short term, it does not cure the patient and, more importantly, there are subgroups of patients who don't experience any benefit from these drugs.

"Our preclinical tests found that cancer cells that have increased Src activity were more sensitive to dasatinib (Sprycel), an FDA-approved drug that inhibits Src, both in tissue culture and when grown as tumors in mice," Thomas said.

But there's also a kicker. Thomas and his colleagues developed a panel of clinical markers that could potentially select patients most likely to benefit from Src inhibitors.

Thomas credits the multidisciplinary approach for the study's success. The importance of Src was discovered because of a sophisticated mass spectrometry based assay, called a phospho-proteomics that analyzes activated proteins.

"We had hypothesized that phospho-proteomic screens could rapidly uncover proteins that could be targets for drugs, so that is why we pursued this line of research," Thomas said.

When the screening process suggested that the Src signaling network was activated, indicating that it was playing a role in the growth of cancer cells, it was a surprise. "Src was certainly was not on my radar," Thomas said.

The next step was to look at the role of Src expression in tumor tissues from patients who had previously had their kidney cancers removed.

"We found that patients with tumors expressing high levels of Src had worse survival rates than those patients whose tumors had weak expression of Src. This suggested to us that Src played a role in kidney cancer and that it was a therapeutic target worth exploring."

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Tuesday, May 31, 2011

Surgeon caseload, practice setting affect treatment of small kidney tumors

ScienceDaily (May 14, 2011) — Patients with small kidney tumors are more likely to be offered treatment options based on surgeons' case volume and type of practice than on tumor characteristics, a Mayo Clinic study has found. Fellowship-trained surgeons who practice in academic medical centers with high volumes of patients with kidney tumors were 70 to 80 percent more likely to follow American Urological Association (AUA) guidelines by recommending partial nephrectomy. Surgeons in private practice who see few patients with kidney tumors more often offered radical nephrectomy: removal of the entire kidney.

See Also:Health & MedicineKidney DiseaseToday's HealthcareBrain TumorWounds and HealingCancerOvarian CancerReferenceRenal cell carcinomaKidneyDialysisExcretory system

Mayo Clinic researchers presented their findings during the AUA Annual Meeting in Washington.

"There is wide variability in how renal masses are managed. We must recognize these discrepancies may be due to different perceptions of technical feasibility in performing a partial nephrectomy," says Christopher Weight, M.D., of Mayo Clinic's Department of Urology. "What we're encouraging is a discussion between physicians and patients about all options available. Some patients may benefit from a referral to surgeons with more experience with renal tumors."

The study shows that as kidney tumors get larger and more complex, all surgeons tend to offer a radical nephrectomy. However, the tumor complexity that may result in one surgeon recommending total removal of the kidney may be well below a more experienced surgeon's threshold. Approximately 45,000 Americans require radical or partial nephrectomy each year.

Other study investigators include Simon Kim, M.D., Christine Lohse, Stephen Boorjian, M.D., R. Houston Thompson, M.D., and Bradley Leibovich, M.D., all of Mayo Clinic; and Rodney Breau, M.D., and Paul Cripsen, M.D., formerly of Mayo Clinic.

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