One day a urine test to screen for kidney cancer?

One of the big issues with kidney cancer today is that we can’t screen for it. Unlike breast cancer, colon cancer, cervical cancer and others, there are no screening methods. We can’t launch a campaign that everyone should have an abdominal ultrasound or CT scan on the off-chance that something might be found. Today, approximately 25% of patients are diagnosed with their kidney cancer after it has already metastasized. Many smaller tumours are found quite by accident during an ultrasound or CT for something else. Mr. Jones, you have a gallstone… but we’ve also found something in your left kidney…

Imagine a day when a simple urine test at your annual physical could detect early signs of kidney cancer. The two studies reported below indicate some potential. Of course, we would still need to know what the appropriate treatment might be for microscopic kidney cancer, but bring on that day!

TWO METABOLON STUDIES PROVIDE INSIGHT INTO KIDNEY CANCER FOR UNIVERSITY OF CALIFORNIA DAVIS

RESEARCH TRIANGLE PARK, N.C. (August 11, 2011) — Metabolon, Inc., the leader in metabolomics, biomarker discovery and biochemical analysis, announces the publication of studies in two peer-reviewed journals that support the use of metabolomics in the diagnosis and treatment of kidney cancer. The studies were conducted by Robert Weiss, M.D. of the Cancer Center at the University of California Davis and colleagues at the University’s Departments of Public Health Sciences and Internal Medicine in collaboration with Metabolon scientists.

The first study, “Urine Metabolomic Analysis Identifies Potential Biomarkers and Pathogenic Pathways in Kidney Cancer,” used metabolomics techniques to identify metabolites in the urine of patients with kidney cancer (renal cell carcinoma, RCC) that appear at different levels compared with patients without kidney cancer. The levels of quinolinate, 4-hydroxybenzoate and gentisate, metabolites involved in common biochemical pathways of specific amino acid and energy metabolism, were significantly different in urine from RCC patients. This result is consistent with protein breakdown and utilization as well as the Warburg effect in kidney cancer tumors. Further, the investigators showed that addition of quinolinate, or α-ketoglutarate, which increased significantly in kidney cancer, stimulated growth in RCC cell lines more than addition of gentisate, which decreased.

The article has been published online in OMICS, A Journal of Integrative Biology and may be accessed by this link: http://www.liebertonline.com/doi/abs/10.1089/omi.2010.0094

The second study, “Urinary Acyl-carnitines Are Altered in Human Kidney Cancer,” compared urine samples from patients with and without kidney cancer, using metabolomics. This study found increases in urinary acyl-carnitines in patients with kidney cancer, with the highest levels associated with high cancer grades. Analysis of a Caki1 mouse xenograft model of human kidney cancer suggest the acyl-carnitines are from tumor tissue and may reflect alterations in metabolism or in cell component synthesis. Since higher chain length acyl-carnitines have an inhibitory effect on NF-kB activation, these metabolites may also reflect changes in immune surveillance, and may help explain the profound chemotherapy resistance seen with this cancer. This study shows for the first time the value of a novel class of metabolites that may lead to new therapeutic approaches for kidney cancer and may prove useful in future cancer biomarker studies.

The article has been published online in The International Journal of Cancer and may be accessed by this link: http://onlinelibrary.wiley.com/doi/10.1002/ijc.26274/abstract

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