Molecular Markers in Predicting Response to Treatment in FH-deficient RCC Patients

RenJi Hospital100 enrolled

Overview

Fumarate hydratase-deficient renal cell carcinoma (FH-deficient RCC) is a rare subtype of RCC characterized by germline/somatic mutation of the fumarate hydratase (FH) gene, and is an extremely aggressive tumor, with a propensity to disseminate early even in the setting of a small primary tumor. This project is a real-world exploratory study aiming to explore potential molecular markers detectable at baseline that can enable the prediction of clinical efficacy of systemic treatments in advanced FH-deficient RCC. This project is a real-world exploratory study aiming to explore potential molecular markers detectable at baseline that can enable the prediction of clinical efficacy of immunotherapy combined with target therapy in advanced FH-deficient RCC. This study aims to include a total of 100 patients initially diagnosed with advanced FH-deficient RCC. Paired tissue and blood samples collected from all patients before or/ and after the start of immunotherapy-based treatment (at diagnosis or/ and their change with treatment) will be analyzed. The patient samples will be submitted for molecular analysis, including next-generation sequencing (NGS)-based gene expression profiling (GEP), RNA-sequencing, multiplex immunofluorescence staining and inflammation-related T-cell receptor (TCR) repertoire profiling, ect. The molecular assay results will include but will not be limited to tumor mutation burden (TMB), microsatellite instability (MSI) status, DNA damage repair (DDR)-related gene mutation status, and programmed death-ligand 1 (PD-L1) expression level. Patients will be followed-up for treatment responses until radiological confirmation of disease progression to immunotherapy-based treatment. The molecular assay results will then be analyzed with clinical data including objective responses and progression-free survival outcomes, among others, to identify molecular markers at baseline that are associated with clinical efficacy of immunotherapy-based treatment.

Study Type

OBSERVATIONAL

Enrollment

100

Conditions

FH-Deficient RCC

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. ≥18 years old; 2. histopathological evidence of FH-deficient RCC, which was confirmed by Sanger or next-generation sequencing after initial screening by IHC. 3. included patients must be diagnosed with metastatic renal cell carcinoma or have a TNM stage IV (according to 2009 TNM Classification); 4. new FH-deficient RCC patients who has scheduled to start 1st cycle of systemic treatment; 5. ECOG score ≤2; 6. life expectancy ≥ 3 months; 7. sign informed consent, and be able to follow the visit and related procedures stipulated in the program; 8. agree to collect tumor tissue, blood and other specimens required by this study and apply them to relevant studies; Exclusion Criteria: 1. patients with other malignant tumors with different primary sites or histology from the tumor evaluated in this study within 2 years of personal history. 2. major surgery or severe trauma within 4 weeks before enrollment; 3. known or suspected active autoimmune diseases (congenital or acquired), such as interstitial pneumonia, uveitis, enteritis, hepatitis, pituitary inflammation, vasculitis, nephritis, thyroiditis, etc. Patients with type 1 diabetes with good insulin control can also be enrolled. 4. known allogeneic organ transplantation (except corneal transplantation) or allogeneic hematopoietic stem cell transplantation; 5. allergic to any component of monoclonal antibody; 6. suffering from other uncontrolled serious diseases, including but not limited to: A) severe infection in the active phase or clinically poorly controlled; B) HIV infection (HIV antibody positive); C) acute or chronic active hepatitis b (HBsAg positive and HBV DNA\>1\*103/ml) or acute or chronic active hepatitis c (HCV antibody positive and HCV RNA\>15IU/ml); D) active tuberculosis, etc.; 7. class iii-iv congestive heart failure (New York heart association classification), poorly controlled and clinically significant arrhythmia; 8. uncontrolled arterial hypertension (systolic blood pressure ≥160mmHg or diastolic blood pressure ≥100mmHg); 9. pregnant or lactating women.

Outcomes

Primary Outcomes

Systemic treatment OS

Systemic treatment OS was defined as the time from the start of systemic treatment to death from any cause, and patients without a recorded death were right censored to the date of last clinical visit or clinical record.

Time frame: Through study completion, an average of 3 year

Secondary Outcomes

First-line PFS

First-line progression free survival (PFS) was defined as the time from the start of first-line systemic treatment to the time of radiographic progression, or death from any cause, whichever occurred first.

Time frame: Through study completion, an average of 3 year

ORR

Objective response rate (ORR) was defined as complete response (CR)+ partial response (PR)

Time frame: Through study completion, an average of 3 year

DCR

disease control rate (DCR) was defined as partial response (PR)+complete response (CR)+stable disease (SD)

Time frame: Through study completion, an average of 3 year

Molecular Markers in Predicting Response to Treatment in FH-deficient RCC Patients

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts