Monitoring levels of the biomarker CA-125 in renal medullary carcinoma (RMC) may help predict disease development or location of metastases, according to data presented at the 2022 International Kidney Cancer Symposium: North America in Austin, Texas.
RMC tends to affect young persons of African descent with sickle hemoglobinopathies. More than 90% of patients with RMC present with advanced disease, according to investigator Kyle A. Blum, MD, MS, of The University of Texas MD Anderson Cancer Center in Houston. Less than 5% of patients survive beyond 3 years.
Dr Blum enrolled 33 patients with an RMC diagnosis confirmed via biopsy or nephrectomy and had serum tumor markers available. They had a median age of 35 years. Of these, 23 (69.7%) were male and 32 (96.9%) were Black. In this cohort, 97% had sickle hemoglobinopathy (such as sickle cell trait) and 31 (93.9%) had metastatic disease.
Using serum tests of known biomarkers in other malignancies, Dr Blum assessed CA-125, CEA, AFP, CA19.9, CA15.3, and LDH. He looked at trends over time with respect to key clinical events including treatment responses, relapses, and disease progression.
Results showed that 82% of patients had elevated CA-125 at any point during their disease course, Dr Blum reported in an oral presentation. Increased metastatic burden was associated with increased CA-125. In metastatic RMC, female patients had higher CA-125 levels compared with male patients. CA-125 levels increases with worsening disease or metastasis burden and decreases with treatment response and decreased metastatic burden, he said.
While LDH and CA-125 were consistently elevated above upper-limit normal ranges, that was not the case for AFP, CA19.9, CA15.3, and CEA.
CA-125 has potential as a marker of disease response and metastatic burden and a potential therapeutic target, Dr Blum said.
Blum KA. Biomarkers of disease burden and treatment response in renal medullary carcinoma. Abstract 2. Presented at: International Kidney Cancer Symposium: North America, November 4-5, 2022, Austin, Texas. Abstract 2.