James Brugarolas, M.D., Ph.D. Answers Questions On: Kidney Cancer
What does UT Southwestern’s Kidney Cancer Program offer patients that sets it apart from other programs of its kind?
Because our Kidney Cancer Program is one of only a few dedicated programs of its kind in the U.S., our physicians and staff have special expertise in caring for patients with kidney cancer.
We deliver the most current evidence-based medical therapies, working closely with related UT Southwestern specialists, including urologists, radiation oncologists, radiologists, pathologists and clinical geneticists, to comprehensively care for our patients with kidney cancer and related conditions.
We offer a number of ancillary support services and programs, as well as opportunities for patients to participate in clinical studies of promising new drugs. When appropriate, patients can meet also with our clinical geneticists, who can help determine if there is a familial risk for kidney cancer that could affect their relatives.
In what areas has the work done in your lab made the greatest impact on kidney cancer?
My team has made key discoveries enabling a more precise understanding of kidney cancer leading to a subclassification of kidney tumors based on mutated genes. Other discoveries have led to the identification of patients most likely to benefit from a particular class of drugs, the mTORC1 inhibitors.
We’ve constructed a pipeline in the laboratory that starts by cataloging the genes that are mutated in kidney cancer – with the recognition that every cancer is different – and finishes with the identification of biomarkers and the design of clinical trials.
This work is leading to new, highly personalized drug therapies that target the disease’s molecular pathways.
What are the unique challenges of treating kidney cancer?
Unlike most other cancer types, kidney cancer doesn’t respond to chemotherapy, which is a big reason there was only one approved treatment for the disease until 2005. Kidney cancer also does not respond to conventional radiation therapy.
In about 30 percent of patients who have had cancerous kidney tumors surgically removed, the cancer returns and spreads (metastasizes). Metastases can affect bones in the spine and hips, which can weaken and fracture. In addition, the cancer can sometimes go to the brain.
Ultimately, the biggest challenge is that we don’t yet have a cure for kidney cancer.