Source: The First Affiliated Hospital
Written by: The First Affiliated Hospital
Edited by: Wang Dongmei

The research results of transformational medicine and precision medicine for renal cancer in China, led by Professor Luo Junhang and Professor Chen Wei from the Department of Urology, The First Affiliated Hospital of Sun Yat-sen University, were published online in The Lancet Oncology (Impact Factor 36.4) on March 14, 2019. This study was supported by grants from the National Key Research and Development Program of China (award number: 2016YFC0902600), and the “5*5” Project of The First Affiliated Hospital, Sun Yat-sen University.

NCCN guidelines recommend that "high-risk" localized renal cell carcinoma (RCC) can be treated with adjuvant targeted therapy postoperative to reduce recurrence. However, about 50% of patients in the "high-risk" subgroup identified by clinicopathological indicators do not have recurrence after operation and do not need expensive adjuvant targeted therapy. In order to increase the predictive accuracy in recurrence of localised RCC and reduce unnecessary adjuvant targeted therapy, 44 SNP loci closely related to postoperative recurrence were screened out from 900,000 SNP loci of Caucasian localized renal cancer in TCGA database. Six loci were found to be closely related to localized renal cancer recurrence in Asians by detecting 44 SNP loci in 227 patients in the training set. The combination of the six SNP loci into a prediction model was further validated in Sun Yat-sen University group (217 cases), domestic multicenter group (410 cases) and TCGA group (441 cases). The results show that the prediction model is an independent factor for postoperative recurrence of localized renal cancer. The combination of the model and clinicopathological indicators can further improve the accuracy of prediction and more accurately identify patients at high risk of recurrence. The journal also published the comments by internationally renowned urologists, Professor Yair Lotan and Professor Vitaly Margulis of Southwest Medical Center of Texas University. They pointed out that “incorporation of molecular markers into clinical practice is important to facilitate a personalised medicine approach so that patients are not treated with a one-size-fits-all approach, which results in overtreatment for some and under-treatment for others”.

Full-text Link Address: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(18)30932-X/fulltext