title: Metastatic clear cell renal cell carcinoma: Circulating biomarkers to guide antiangiogenic and immune therapies.
abstract: The therapeutic armamentarium for metastatic renal cell carcinoma has rapidly expanded over the past decade to include a number of anti-angiogenic therapies and more recently, an immunotherapy. Biomarkers in the peripheral circulation are easily accessible, can provide important prognostic value, and have the potential to give important information about disease progression and treatment sensitivity or response.
  
  
  
  Herein, we review a variety of circulating markers including circulating protein markers (VEGF-A, inflammatory cytokines, and LDH), circulating nucleic acids (cell free DNA and micro RNAs), and circulating cellular factors (circulating tumor cells, circulating endothelial cells, and immune cell subsets). We discuss these biomarkers in the context of their ability to provide prognostic and predictive information to anti-angiogenic and immunotherapeutic agents.
  
  
  
  While promising, there is still much work to be done, and prospective evaluation of any potential predictive biomarker for these therapies is greatly needed.
authors: Department of Medicine, Duke Cancer Institute, Duke University Medical Center, Durham, NC. Electronic address: tian.zhang2@duke.edu.
authors: Tian
authors: T
authors: Zhang
authors: Department of Medicine, Duke Cancer Institute, Duke University Medical Center, Durham, NC.
authors: Jason
authors: J
authors: Zhu
authors: Department of Medicine, Duke Cancer Institute, Duke University Medical Center, Durham, NC; Department of Surgery, Duke Cancer Institute, Duke University Medical Center, Durham, NC.
authors: Daniel J
authors: DJ
authors: George
authors: Department of Medicine, Duke Cancer Institute, Duke University Medical Center, Durham, NC.
authors: Andrew B
authors: AB
authors: Nixon
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood*; D002292:Carcinoma, Renal Cell / Q000097:blood / Q000556:secondary* / Q000628:therapy; D016207:Cytokines / Q000097:blood; D004273:DNA, Neoplasm / Q000097:blood; D042783:Endothelial Cells; D006801:Humans; D007167:Immunotherapy; D007680:Kidney Neoplasms / Q000097:blood* / Q000628:therapy; D018655:Lymphocyte Count; D009363:Neoplasm Proteins / Q000097:blood; D009360:Neoplastic Cells, Circulating; D012334:RNA, Neoplasm / Q000097:blood; D016176:T-Lymphocyte Subsets; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: D020533:Angiogenesis Inhibitors; D014408:Biomarkers, Tumor; D016207:Cytokines; D004273:DNA, Neoplasm; D009363:Neoplasm Proteins; D012334:RNA, Neoplasm; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A
keywords: Circulating biomarkers; Circulating tumor DNA; Circulating tumor cells; Immunotherapy; Metastatic renal cell carcinoma; VEGF therapies