What causes this site-specific migration?

Most people with kidney cancer don’t have metastasis to the brain. But 15 percent of patients with advanced kidney cancer do, says urologic oncologist Nirmish Singla, M.D., M.S.C.S., Director of the Kidney Cancer Program. “These patients have traditionally exhibited poor outcomes, yet they remain largely understudied, both clinically and biologically. Although patients with brain metastases are among the most challenging to treat, they are often excluded from prospective clinical trials.”

What causes renal cell carcinoma (RCC) to move into the brain? Singla and neurosurgeon Chetan Bettegowda, M.D., Ph.D., the Jennison and Novak Families Professor of Neurosurgery, are determined to find out, looking for factors in RCC tumors that may be responsible for this site-specific migration.

“Our team is uniquely positioned to shed light on the biology of brain metastasis: we have a robust cohort of patients who underwent neurosurgical resection of at least one brain metastasis at Johns Hopkins,” with tissue available for analysis.

“By studying the molecular underpinnings of brain metastases, our research may help guide future biomarker discovery in bodily fluids to help monitor response to treatment in these patients. And by uncovering biological clues in metastatic tumors, we hope our findings may help guide clinicians in selecting more effective treatments for these patients.” Singla is Principal Investigator of this study, funded by grants from the Kidney Cancer Association and the American Urological Association.