14 RCC and control plasma samples were collected and then underwent a pathway specific targeted Liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay of 400 metabolites from 35 pathways. Out of this process, 131 metabolites were detected and 33 metabolites had altered levels in RCC. Moreover, 22 metabolites had a greater than 2-fold difference in RCC patients.
Dr. Lee found that metabolic profiling from a simple plasma blood draw can identify specific differences in RCC compared to controls. The plasma samples can be run from normal blood draws and there are no specific issues with preservation of the samples. This is very convenient as blood draws occur regularly in the health care setting. Although there is not a method to run this test from urine, this is still very convenient to run from normal serum assays.
This may allow for more specific markers to be detected for both diagnosis and surveillance. Looking for biomarkers to be predictive is a hot topic in the field of precision medicine. Dr. Benjamin stated that these are important because this “…may imply more aggressive RCC – instead of receiving partial nephrectomy, [the] patient may be counseled for radical nephrectomy.” Furthermore, regarding surveillance, if certain markers are positive for example, the schedule for surveillance imaging may altered. However, further studies must be done with larger cohorts needed to clinically validate these methods. Also, the cost effectiveness of these tests have not yet been evaluated either.
Presented by Benjamin R Lee, MD, University of Arizona College of Medicine –Tucson Department of Surgery
Written by: John Sung, Department of Urology, University of California-Irvine, medical writer for UroToday.com. at the 36th World Congress of Endourology (WCE) and SWL - September 20-23, 2018 Paris, France