How Do Molecular Factors Impact Response to Immunotherapy in Kidney Cancer?

Dr. David A. Braun sat down for an interview with CURE® to discuss a study, on which he is a co-author, and delved into the molecular factors which drive exceptional responses to immunotherapy in metastatic clear cell renal cell carcinoma (ccRCC), a type of kidney cancer.

According to Braun and other co-authors, data derived from the evaluation showed that specific molecular factors, including a higher load of clonal neoantigens or robust B-cell receptor signaling, led to patients having a more “exceptional” response to their immunotherapy compared with patients who did not have these doctors.

Braun, an Assistant Professor of Medicine, Medical Oncology, and a Louis Goodman and Alfred Gilman Yale Scholar, at the Yale School of Medicine, as well as a member of the Center of Molecular and Cellular Oncology at Yale Cancer Center, in New Haven, Connecticut, shared his insights into this in the interview, expanding on the importance of how findings like these provide hope or reassurance to patients who may feel uncertain about their treatment options.

Transcript:

The short-term key is a message of hope; there really is the potential for these exceptional responses. However, I think that is something we have to balance in our clinic. I see patients with kidney cancer every week, [and have to ensure transparency when discussing] where we are today — we have to be realistic about that — but also where we hope to be in the future. Where we are today, the majority of patients, unfortunately, are not getting that long-term benefit. But it's also not zero.

There really are truly a set of patients that today who might have exceptional long-term benefit from immune therapy, and that has to factor into our thinking and their thinking [though we don't have a perfect way of saying [who] in a clinical test upfront right now.] The hope is that in the coming years that many groups, not just our collaborative group, but many others that are working on kidney cancer nationwide and internationally, push the field forward.

It is hoped that we take lessons like these and make those exceptional responders, not just a small fraction, but larger and larger. That's the lesson I hope to take from [the study]. I always want to be honest and practical about where we are today, that [these are] still not the majority of patients, but hopefully with the lessons learned, we can begin to move towards that.

Transcript has been edited for clarity and conciseness.

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