Many of today’s imaging tools can alert doctors to abnormalities such as a lump but can’t provide more precise information, such as whether the lump is cancerous, and if so, what type. Now a diagnostic scan may become available that is capable of distinguishing one of the most common and deadly forms of kidney cancer. As one of the first scans capable of providing information on tumor type, such a tool would help physicians and patients make more informed decisions.
The new diagnostic tool could help patients and doctors pick the most appropriate treatment
Kidney cancer is often diagnosed radio graphically, when a mass is detected on a CT or MRI scan—tests that cannot distinguish among cancer types, which carry varying levels of risk. As more Americans undergo scans as part of evaluation for a variety of ailments, the number of kidney tumors detected incidentally has increased, such that up to 70 percent are now discovered that way.
Many of the patients whose scans show kidney masses undergo surgery, and in some cases their tumors turn out to be benign, meaning they wouldn’t necessarily have required immediate surgery. But in the absence of a definitive presurgical diagnosis, surgeons often operate be safe.
Fox Chase surgeons and nuclear medicine physicians recently participated in a national, Phase III clinical trial that demonstrated that the use of an antibody called 124I-girentuximab, or G250, combined with PET or CT imaging, can distinguish clear-cell renal cell carcinoma from other types of kidney masses. If approved by the Food and Drug Administration, the test would be one of the first disease- specific molecular scans capable of not only identifying a tumor’s origin and location but also providing data on its cell type, arming physicians and patients with critical information.
“The ability to distinguish preoperatively between aggressive and less aggressive kidney masses is a critical challenge,” says Robert G. Uzzo, chairman of the department of surgery, who presented the findings in June at the annual meeting of the American Urological Association. “Such information has a significant impact on the patient by giving physicians the ability to match tumor biology to the most appropriate treatment.”
The antibody, which binds to a unique protein expressed on the cells of clear-cell renal cell carcinoma, is injected intravenously as part of a PET or CT scan. The scan holds promise for earlier detection and treatment of advanced disease.