Imaging Innovations Could Lead to Better Kidney Cancer Treatment

An emerging imaging-based approach called spatial transcriptomics could change how doctors diagnose and treat kidney cancer. This technology shows where genes are active in the tissue, giving researchers a map of how cells function in their natural environment. 

Mitchell Hayes, MD, a urologic oncology fellow at Moffitt Cancer Center, and a team are leading research into how this method can help personalize treatment and improve outcomes for patients with two types of kidney cancer: clear cell and papillary renal carcinoma. 

Mitchell Hayes, MD

“The way we diagnose kidney cancer now largely depends on pathologists analyzing tissue samples using a few stains under the microscope, but these spatial analyses are a little bit more quantitative,” Hayes said. “They use stains, but the thing that has projected this type of analysis into the future is the number of stains that we can look at one given time.” 

One research project currently underway focuses on why some patients develop resistance to immunotherapy, a primary treatment option for kidney cancer. While some patients experience long-lasting responses, most eventually stop responding. Using spatial transcriptomics, Hayes and his team identified two genes — integrin and collagen 4 — that may play a role in resistance.  

With funding from the Kidney Cancer Association, they are expanding their current study to include 50 patients from Moffitt. 

“We hope to see many more new findings because we’ve expanded the panel from 1,000 genes to 6,000 genes. It speaks to the number of markers we can look at simultaneously. Now, we’re looking at 6,000 different genes in a single slide,” Hayes said. 

The second project, backed by an upcoming U.S. Department of Defense grant, focuses on papillary renal cell carcinoma, a less common form of kidney cancer that can also be resistant to treatment.  

Research found clusters of immunosuppressive macrophages — a type of white blood cell that usually helps regulate the immune system — may contribute to the cancer’s ability to evade treatment. If confirmed, these findings could lead to new therapeutic targets. 

Hayes hopes this research will revolutionize kidney cancer treatment by identifying predictive and prognostic biomarkers — image-based indicators that could guide doctors in choosing the most effective therapies for each patient. 

“The thing that motivates me is that moment when we see patients in clinic six months after they’ve had a surgery, and there’s no evidence of disease,” Hayes said. “We keep fighting for patients. We want to find new ways of helping those patients and try to get rid of cancer in the long run.” 

March is Kidney Cancer Awareness Month, and knowing your risk is important. Most patients diagnosed with kidney cancer that has not spread do not experience symptoms, and the disease can go unnoticed until it is found during screenings for other health issues. 

However, if the tumors are larger or in the central part of the kidney, symptoms could include blood in the urine, flank or abdominal pain and changes in appetite. Hayes also urges people to be aware of their family history. 

“Immunotherapy has revolutionized the way we treat kidney cancer. A lot of kidney cancer patients are living longer,” Hayes said, “It’s good to know this is more like a chronic condition that a lot of folks are struggling with on a day-to-day basis. A diagnosis can happen to anyone, so it’s good to be aware.”