Cancer associated macrophage-like cells in metastatic renal cell carcinoma predicts for poor prognosis and tracks treatment response in real time

Sep 24, 2026

Uploaded by Jacob

Renal cell carcinoma (RCC) has a high mortality rate, and metastatic RCC outcomes remain limited by treatment resistance and toxic side effects. Current blood-based biomarkers such as white blood cells, hemoglobin, and platelets provide restricted prognostic value. Cancer associated macrophage-like cells (CAMLs) offer a potential biomarker because their number and size relate to poor clinical outcomes. In blood samples from 40 RCC patients, CAML changes were monitored during treatment to assess real-time predictive and prognostic utility, showing smaller CAMLs associated with better progression-free and overall survival.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Background

Limitations of existing blood biomarkers

Treatment context and resistance

CAMLs as candidate biomarkers

Methods

Patient cohort and blood sampling

Monitoring CAMLs during treatment

Results

Association with progression-free survival

Association with overall survival

Implications

Diagnostic, prognostic, and predictive potential

[www. nature.com/scientificreports](www. nature.com/scientificreports) OPEN Cancer associated macrophage‑like cells in metastatic renal cell carcinoma predicts for poor prognosis and tracks treatment response in real time Amama Ali1, Daniel L. Adams1*, Dimpal M. Kasabwala1, Cha‑Mei Tang2 & Thai H. Ho 3 Renal Cell Carcinoma (RCC) is a fatal urological cancer, with one third of patients diagnosed with metastasis, resulting in a 5‑year survival of only 12% . Recent advancements in therapies have increased survival in mRCC, but lack efficacy in subtypes, due to treatment resistance and toxic side effects. Currently, white blood cells, hemoglobin, and platelets are limitedly used as blood based biomarkers to help determine RCC prognosis. Cancer associated macrophage‑like cells (CAMLs) are a potential mRCC biomarker which have been identified in peripheral blood of patients with malignant tumors and have been shown to predict poor clinical patient outcomes based on their number and size. In this study, blood samples from 40 RCC patients were obtained to evaluate the clinical utility of CAMLs. CAML changes were monitored during treatment regimensto evaluate their ability to predict treatment efficacy. It was observed that patients with smaller CAMLs had better progression free survival (HR = 2.84, 95% CI 1.22–6.60, p = 0.0273) and overall survival (HR = 3.95, 95% CI 1.45–10.78, p = 0.0154) versus patients with larger CAMLs. These findings suggest that CAMLs can be used asa diagnostic, prognostic, and predictive biomarker for patients with RCC which may help improve management of advanced RCC. Abbreviations RCC Renal cell carcinoma mRCC Metastatic renal cell carcinoma ccRCC Clear cell renal cell carcinoma MTSCC Mucinous tubular and spindle cell carcinoma CAML Cancer associated macrophage-like cell PFS Progressive free survival OS Overall survival HR Hazard ratio CI Confidence interval IMDC International mRCC database consortium IRB Institutional review board WBC White blood cell Renal cell carcinoma (RCC), the 8th most common cancer, forms from renal tubular epithelial cells and makes up over 80% of all kidney cancers, with clear cell RCC being the largest subtype1,2. RCC affects ~ 79,000 individuals in the United States and results in ~ 13,900 deaths annually with incidence in men being 50% higher than in women and more common in people over the age of 60 years old3,4. The most common genetic cause for RCCis a disease of the Von-Hippel Lindau gene, while established non-genetic factors include smoking, obesity, hypertension, and chronic kidney disease4. In the past two decades, approximately 50% of RCC diagnoses were 1Creatv Bio, Division of Creatv MicroTech, Inc., 9 Deer Park Dr, Monmouth Junction, NJ 08852, USA. 2Creatv Bio, Division of Creatv MicroTech, Inc., 9900 Belward Campus Dr., Rockville, MD 20850, USA. 3Division of Hematology/Oncology, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA. *email: dan@ [creatvmicrotech.com](creatvmicrotech.com) [www. nature.com/scientificreports/](www. nature.com/scientificreports/) made due to incidental detection through newer imaging technologies resulting in ~ 33% RCC diagnoses being made at the metastatic stage4. The International mRCC Database Consortium (IMDC) risk calculator is a well-established tool which can help predict survival outcomes in mRCC patients3,5. The IMDC uses multiple factors (hemoglobin level, time from diagnosis to start of treatment, neutrophil count, etc.) to determine whether a patient is in a good, intermediate, or a poor-risk grouping3,5. The patient’s categorical estimate can help doctors determine the type of first line therapy to use on patients5. To treat RCC, surgery is still the first choice for treating non-metastasized disease, while systemic targeted therapies (i.e. Pazopanib, Axitinib, etc.), and more currently PD-1 inhibiting immunotherapies (i.e. Nivolumab, Ipilimumab, etc.), are used as neoadjuv

FAQs

What role do cancer associated macrophage-like cells (CAMLs) play in metastatic renal cell carcinoma?

CAMLs are proposed as a biomarker in metastatic renal cell carcinoma because their number and size in peripheral blood have been linked to poor patient outcomes. The study evaluates their clinical utility by tracking CAML changes during therapy.

How were CAMLs evaluated to predict treatment outcomes in this study?

Blood samples from 40 RCC patients were collected, and CAML changes were monitored across treatment regimens. This monitoring was used to assess whether CAMLs could predict treatment efficacy and survival outcomes.

What survival differences were associated with CAML size?

Patients with smaller CAMLs showed better progression-free survival and overall survival than patients with larger CAMLs. The reported hazard ratios and p-values indicate statistically significant associations.

Sep 24, 2026

Uploaded by Jacob