1. Academic Validation
  2. Identification of therapeutic targets for renal medullary carcinoma via integrated genomic and transcriptomic profiling

Identification of therapeutic targets for renal medullary carcinoma via integrated genomic and transcriptomic profiling

  • Cell Rep Med. 2025 Oct 30:102423. doi: 10.1016/j.xcrm.2025.102423.
Pavlos Msaouel 1 Nizar M Tannir 2 Funda Meric-Bernstam 3 Jennifer M King 4 Martin H Voss 5 Jessica P Cheng 2 Susan S Thomas 2 Zita D Lim 2 Menuka Karki 6 Rong He 6 Giannicola Genovese 7 Rahul A Sheth 8 Davis R Ingram 9 Diana Shamsutdinova 9 Khalida M Wani 9 Wei-Lien Wang 10 Alexander J Lazar 11 Dominique Knipper-Davis 12 Amber Berlinski 12 Tayla Soares 12 Danil Stupichev 12 Kirill Kryukov 12 Suren Davitavyan 12 Anna Novokreshchenova 12 Dmitry Lebedev 12 Stanislav Kurpe 12 Andrey Kravets 12 Dmitrii Belousov 12 Michael Hensley 12 Alexander Bagaev 12 Francesca Paradiso 12 Vladimir Kushnarev 12
Affiliations

Affiliations

  • 1 Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; David H. Koch Center for Applied Research of Genitourinary Cancers, The University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA; The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences (GSBS), Houston, TX, USA. Electronic address: pmsaouel@mdanderson.org.
  • 2 Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • 3 Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
  • 4 Division of Hematology-Oncology, Indiana University Simon Comprehensive Cancer Center, Indianapolis, IN 46202, USA.
  • 5 Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
  • 6 Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; David H. Koch Center for Applied Research of Genitourinary Cancers, The University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA.
  • 7 Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; David H. Koch Center for Applied Research of Genitourinary Cancers, The University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA; Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • 8 Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • 9 Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • 10 Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
  • 11 Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
  • 12 BostonGene Corporation, Waltham, MA 02453, USA.
Abstract

Renal medullary carcinoma (RMC) is a rare but highly aggressive kidney Cancer that resists conventional therapies. To identify therapeutic targets, this study employs histopathologic, genomic, and transcriptomic profiling of 25 RMC samples. TROP2, EPCAM, CLDN6, and CDH6 are significantly overexpressed compared with Other renal and solid tumors. Pathway analyses indicate Hippo pathway upregulation and a tumor microenvironment rich in fibroblasts and neutrophils. We subsequently explore treatment of four heavily pretreated patients, all with high TROP2 expression, using sacituzumab govitecan, a TROP2-targeted antibody-drug conjugate. Of these four patients, one patient achieves a partial response with symptom improvement, two patients maintain stable disease, and the median progression-free survival reaches 2.9 months. This study represents the most extensive molecular characterization of RMC to date, identifying TROP2 and Other potential therapeutic targets. Sacituzumab govitecan demonstrates potential clinical benefit, warranting further evaluation in prospective trials to confirm its efficacy and explore additional targets identified herein.

Keywords

CDH6; CLDN6; EPCAM; Hippo pathway; SMARCB1; TROP2; renal medullary carcinoma; sacituzumab govitecan.

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