Renal Cancer Clinical Trial
Official title:
The Immune and Inflammatory Profile of Patients After Image Guided Ablation of Renal Cancer With Radiofrequency Ablation (RFA)/ Microwave Ablation (MWA) vs. Cryoablation (CRYO)
Often kidney cancer is diagnosed when the tumour is small and hasn't spread. Rather than major surgery to remove the whole kidney, image-guided ablation involving heat (microwave or radiofrequency) or freezing (cryotherapy) is often used to destroy the tumour using minimal invasive technique with much less risk and discomfort. Limited evidence suggests that ablation also activates the immune system which may help in fighting the cancer. We will investigate the immune and other changes by analysing blood samples from patients before and after ablation. Understanding this will help in designing more effective new treatments combining ablation with biological therapies.
Image-guided ablation therapies are increasingly being used in renal and other cancers as an
alternative to major surgery, particularly in the context of small localised masses or when
patients have significant co-morbidities. Published analyses now also support the
effectiveness of such treatments in terms of outcomes. Tumour ablation has been reported to
generate immune and inflammatory responses following tumour destruction, essentially through
release of tumour antigens in effect acting as a tumour "vaccine", resulting in systemic
anti-tumour responses. Such studies are still limited but indicate possibilities in terms of
combination therapies with immunotherapies and synergistic effects.
In order to take this forward in renal cancer it is now critical that studies are undertaken
to explore further the immunobiological and inflammatory changes associated with ablation
therapies. We propose to do this using a relatively new multiplex and highly sensitive
proteomic biomarker array technology which allows the profiling of circulating proteins using
arrays targeted at specific disease areas or processes. We have used this platform to
generate some pilot data on RCC patients undergoing ablation to show feasibility and now
propose to extend this further. The main benefits to patients will be in terms of
understanding how the immune and inflammatory responses are affected by ablation which
ultimately may lead to the design of new more effective therapeutic strategies combining
ablation with immunotherapies. Ultimately more effective combination therapies would have
health economic benefits and improved quality of life with potentially lower toxicity if the
doses of the biological therapies could be reduced. Some of the protein changes may also act
as surrogate markers of response and guide optimal treatment administration.
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