With an estimated 81,610 new cases and 14,390 deaths, kidney cancer is among the most common cancers in the United States, according to the NIH’s National Cancer Institute. Kidney cancer is a disease in which cancer cells form in the tissues of the kidney. The main types of kidney cancer are:

• Renal cell cancer.
• Transitional cell cancer.
• Wilms tumor.

Most of the time, kidney cancer risk is not passed down from parent to child. Kidney cancer that affects multiple generations of a family is called hereditary kidney cancer. Accounting for only 5% to 8% of all kidney cancer cases, hereditary kidney cancer is linked to hereditary cancer syndromes, which are caused by inherited genetic mutations and increase the risk of certain cancers. These hereditary cancer syndromes are:

• Hereditary leiomyomatosis and renal cell cancer (HLRCC).
• von Hippel-Lindau disease (VHL).
• Birt-Hogg-Dubé syndrome (BHD).
• Hereditary papillary renal cancer (HPRC).
  

"Maintaining a healthy lifestyle, avoiding smoking and managing other risk factors, such as obesity, can reduce the risk of developing kidney cancer,” explained Alberto Martini, MD, a clinical researcher at the Cancer Center and director of research in the Department of Urology. “Many cases of kidney cancer go unnoticed in the early stages due to a lack of symptoms and are only discovered through imaging for other health concerns. However, breakthroughs in treatment, including less invasive surgeries and novel drug therapies, have greatly enhanced survival rates, even for those with advanced disease.”

Alberto Martini, MD Associate Member, Experimental Therapeutics Pathways Research Program University of Cincinnati Cancer Center Director of Research, Department of Urology University of Cincinnati College of Medicine

Different types of treatments are available for those with renal cell cancer, transitional cell cancer and Wilms tumor. Patients will work together with their cancer care team to decide the treatment plan, which could include more than one type of treatment, and many factors will be considered, such as the stage of the cancer, the patient’s overall health and the patient's preferences. The following types of treatment may be considered:

• Surgery.
• Chemotherapy.
• Immunotherapy.
• Targeted therapy.

Over the past five years, we have seen the approval of several immunotherapy and combination treatments,” Martini said. “Those treatments have transformed the way advanced and metastatic kidney cancer is treated. Today, many patients can hope for a complete response to treatments for advanced cancer. For patients with localized disease, the rate of surveillance for small renal masses has increased.”

“Looking toward the future, I see the field moving further in the direction of personalized medicine, with treatment plans that are tailored based on genetic markers, tumor characteristics and patient factors,” Martini added.

For example, one project focused on improving surveillance strategies for patients who have undergone surgery for localized kidney cancer is the Oncologic Surveillance After Surgical Treatment for Clinically Localized Kidney Cancer: UroCCR multicenter study that Dr. Martini is leading.

“In 2021, the European Association of Urology (EAU) Guidelines introduced a new follow-up framework,” he shared. “Based on expert opinion, patients were categorized into three risk groups for both clear cell renal cell carcinoma (ccRCC) and non-clear cell renal cell carcinoma (non-ccRCC) after curative surgery. Our objective was to validate this system and provide data-driven recurrence estimates for these risk categories.”

Dr. Martini and his team analyzed data from 5,320 patients across twenty-eight French referral centers, evaluating the likelihood of both loco-regional and distant recurrence, and their findings offered key insights to enhance the current surveillance strategies.

“Based on our analysis, we proposed refinements to the EAU follow-up system, suggesting reduced imaging frequency for certain risk groups to potentially lower healthcare costs and minimize radiation exposure,” he said. “Next, we aim to further validate these revisions through extended follow-up and larger datasets, working towards integrating them into clinical practice. While the American Urological Association has its own expert-opinion-based follow-up recommendations, we are collaborating with the EAU to validate our findings and move towards an internationally standardized surveillance protocol informed by recurrence data and improved risk stratification.”

Dr. Martini also highlighted the valuable opportunities that come with being a part of the Cancer Center, emphasizing how it has helped foster meaningful collaborations with top experts.

“Being a member of the Cancer Center has allowed me to connect with leading kidney cancer researchers, like Dr. Maria Czyzyk-Krzeska whose work is making significant contributions to the field,” he said. “This membership has also facilitated my collaboration with Dr. Shesh Rai, and we have continuously discussed innovative methodologies for data analysis.”