Evaluating Renal Mass Biopsy and Nephrectomy in Small Renal Masses

A study sought to evaluate how accurately prospectively collected renal mass biopsy (RMB) can identify DNA mutations in nephrectomy specimens. The results were presented at the 2022 International Kidney Cancer Symposium: North America.

To conduct this analysis, called GRADE-SRM (Genomic Risk Assessment and Decisional Evaluation for Small Renal Masses), Kathryn H. Gessner, MD, PhD, and colleagues analyzed 43 patients who underwent both RMB and surgery. The researchers noted that mutation concordance was defined as percent of mutations in nephrectomy specimen also identified in the biopsy.

Overall, 14 patients with clear cell renal cell carcinoma had tissue from both procedures collected and used for analysis. The results showed that mutation concordance between paired nephrectomy and RMB specimens ranged from 0% to 83%, and multifocal samples from nephrectomy specimens generally showed a higher concordance to nephrectomy specimens.

“These results highlight that additional sampling may be necessary to use prognostic information from RMB to guide clinical decision-making,” the researchers concluded. They added that future studies “will focus on evaluating the concordance of known [renal cell carcinoma] driver mutations and investigating transcriptomic similarities between RMB and nephrectomy specimens.”

Source: Gessner K, Simon J, Myers S, et al. Prospective evaluation of mutation concordance between standard-of-care renal mass biopsy and nephrectomy specimens in small renal masses. Poster 46. Presented at the 2022 IKCS: North America; November 4-5, 2022; Austin, Texas.