Among patients with kidney cancer, the activity of four specific genes in the cancer cells seems to be able to predict the risk of the tumour spreading and the patient’s chances of survival. This is shown by researchers from Karolinska Institutet in Sweden in a preclinical study published in Nature Communications.

“This could potentially become a tool to gain a better understanding of the course of the disease at an early stage. Patients with a cancer profile with a high probability of spreading could then be monitored more closely, to quickly detect and treat any growth of the tumour,” says Ninib Baryawno, senior researcher at the Department of Women’s and Children’s Health, Karolinska Institutet, and the study’s last author.

Clear cell kidney cancer is the most common form of kidney cancer in adults. If the tumour is confined to the kidneys, the prognosis is often favourable, but if it has spread to the skeleton, which occurs in about a third of patients, the five-year survival rate is only about ten per cent.

Immunotherapy known as checkpoint inhibitors have in recent years become an important treatment for patients with clear cell kidney cancer. But it is common for the cancer cells to develop resistance to the treatment, which may partly be attributed to factors in the environment around the cancer cells, the so-called tumour microenvironment.

In the current study, the researchers examined samples from nine patients with clear cell kidney cancer. The study is a collaboration between researchers at Karolinska Institutet, clinicians at Massachusetts General Hospital, where the patients were recruited, and computational scientists from Harvard Medical School in Boston, USA.

Both tumour tissue and nearby normal kidney tissue were collected from the same patient to be able to make matched comparisons and control for inter-individual variation. The cells were studied by single-cell analysis; a sequencing technique that makes it possible to investigate each single cell in the tissue and the gene expression, that is, which genes are active, in individual cells.

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