Stromal FAP expression in advanced clear cell renal cell carcinoma was associated with shorter disease-free and overall survival, and a lower likelihood of complete response to TKI therapy.
Cohort (n=137)
Does stromal FAP expression predict disease recurrence and response to first-line TKIs in patients with advanced clear cell renal cell carcinoma?
Stromal FAP expression serves as a potential prognostic and predictive biomarker for shorter survival and poorer response to TKI therapy in advanced clear cell renal cell carcinoma.
Despite advances in the management of advanced clear cell renal cell carcinoma (ccRCC), robust biomarkers for prognosis and therapeutic response prediction remain elusive. Fibroblast activation protein-α (FAP), a marker of activated cancer-associated fibroblasts (CAFs), has emerged as a potential indicator of tumor aggressiveness and resistance to systemic therapies in various solid tumors. This study evaluated the clinical relevance of stromal FAP expression in a cohort of 137 patients with advanced ccRCC and long-term follow-up. FAP immunohistochemistry (IHC) was performed on primary tumor specimens and correlated with key clinicopathological features, disease-free survival (DFS), overall survival (OS), and radiological response to first-line tyrosine kinase inhibitors (TKIs). A significantly higher percentage of FAP-positive CAFs was observed in primary tumors with high histological grade, extensive local invasion (pT3-4), and advanced clinical stage (NCCN stage III-IV). Stromal FAP expression was associated with shorter DFS and OS. Moreover, tumors lacking FAP expression were more likely to achieve complete response to TKI therapy as defined by RECIST criteria. These findings highlight the potential of FAP IHC as a prognostic and predictive tool in advanced ccRCC and support further clinical validation.
Montes et al. (Mon,) conducted a cohort in Advanced clear cell renal cell carcinoma (ccRCC) (n=137). Stromal FAP expression vs. Lack of FAP expression was evaluated on Disease-free survival (DFS), overall survival (OS), and radiological response to first-line TKIs. Stromal FAP expression in advanced clear cell renal cell carcinoma was associated with shorter disease-free and overall survival, and a lower likelihood of complete response to TKI therapy.