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The Use of Reverse Phase Protein Arrays (RPPA) to Explore Protein Expression Variation within Individual Renal Cell Cancers
Published on: January 22, 2013
Refining Prognostic Stratification in Clear Cell Renal Cell Carcinoma: Genomic, Tissue-Based, Circulating Biomarkers
Mariana Bianca Chifu1, Simona Eliza Giușcă1,2, Andrei Daniel Timofte1,2
1Department of Morfofunctional Sciences 1, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania.
Cancers
|May 13, 2026
Summary
Prognostic biomarkers for clear cell renal cell carcinoma (ccRCC) are being investigated to improve risk stratification. While several markers show promise, integrated models combining genomic, tissue, immune, and circulating factors are needed for clinical use.
Area of Science:
- Oncology
- Biomarker Discovery
- Genitourinary Cancers
Background:
- Clear cell renal cell carcinoma (ccRCC) exhibits significant biological heterogeneity, challenging conventional prognostic models.
- Accurate risk stratification is crucial for effective management across all disease stages.
- Novel biomarkers are needed to enhance prognostic accuracy beyond traditional clinicopathological factors.
Purpose of the Study:
- To critically review and appraise the evidence for prognostic biomarkers in ccRCC published over the last decade.
- To analyze biomarkers across genomic, tissue-based, circulating, and integrated predictive model domains.
- To assess the individual and combined value of biomarkers in relation to clinical factors and survival.
Main Methods:
- Narrative review of peer-reviewed literature from the past 10 years.
- Analysis structured into four domains: genomic, tissue-based, circulating biomarkers, and integrated models.
- Critical appraisal of evidence regarding biomarker association with ccRCC prognosis and survival.
Main Results:
- Chromosome 3p alterations, particularly BAP1 loss, are key molecular features associated with aggressive ccRCC behavior.
- SETD2/H3K36me3 disruption and PD-L1 expression show context-dependent prognostic associations.
- Plasma KIM-1 and circulating tumor DNA (ctDNA) show potential but face limitations in sensitivity and standardization.
- Systemic inflammatory indices like neutrophil-to-lymphocyte ratio correlate with outcomes but reflect general inflammation.
Conclusions:
- No single biomarker is currently sufficient for routine prognostic implementation in ccRCC.
- Integrated models combining multi-omic data with clinical variables hold future promise.
- Prospective validation and demonstration of incremental clinical utility are essential for adopting new prognostic strategies.