Identifying Patients With High-Risk RCC Who May Benefit From Atezolizumab

Results from the IMmotion010 trial demonstrated that adjuvant atezolizumab did not lead to an increase in investigator-assessed disease-free survival (DFS) compared with placebo following resection in patients with renal cell carcinoma (RCC).

A study from Laurence Albiges, MD, PhD, and colleagues presented at the 2024 American Society of Clinical Oncology Annual Meeting investigated the potential of patients with high-risk RCC and measurable residual disease (MRD) to benefit from treatment with atezolizumab.

Dr. Albiges and colleagues conducted a retrospective proteomics analysis to analyze circulating proteins with differential abundance patterns in matched serum samples using an affinity-based proximity extension assay (PEA) panel of 3000 analytes. KIM-1 levels were evaluated using a high-sensitivity electrochemiluminescence (ECL) assay.

Upon recurrence versus baseline, circulating KIM-1 was found to be the most notably enriched protein among patients with matched PEA samples (n=73). Of the patients in the IMmotion010 trial, 752 (97%) reported baseline KIM-1 data.

Researchers noted that a KIM-1 high status was related to a decreased DFS and an improved DFS in patients who received atezolizumab compared with placebo. In KIM-1 high patients, 9% and 20% demonstrated a ≥30% increase from baseline at cycle 4, day 1, with atezolizumab versus placebo, compared with 16% and 12% in KIM-1 low patients.

In both the KIM-1 high and low cohorts, an increase of ≥30% was associated with decreased DFS. The median KIM-1 levels were increased at recurrence (P<.001) more than baseline for patients with matched ECL samples (n=103).

“In IMmotion010, high baseline serum KIM-1 levels were associated with poorer prognosis but improved clinical outcomes with atezolizumab versus placebo,” researchers wrote. “Increased post-treatment KIM-1 was associated with worse DFS. These data suggest that circulating KIM-1 may be a noninvasive marker of MRD and disease recurrence and be associated with benefit from atezolizumab in adjuvant RCC.”