Publications by authors named "Kapur P"

Neoadjuvant systemic treatment strategies have improved outcomes in several solid tumour types. This success has not yet been replicated in renal cell carcinoma (RCC). A consensus and international collaboration are urgently needed for the development of adaptive perioperative immunotherapy strategies for patients with RCC at high risk of recurrence.

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Purpose: A reliable and comprehensive cancer prognosis model for clear cell renal cell carcinoma (ccRCC) could better assist in personalizing treatment. In this work, we developed a multi-modal ensemble model (MMEM) which integrates pretreatment clinical information, multi-omics data, and histopathology whole slide image (WSI) data to learn complementary information to predict overall survival (OS) and disease-free survival (DFS) for patients with ccRCC.

Methods And Materials: We collected 226 patients from The Cancer Genome Atlas Kidney Renal Clear Cell Carcinoma dataset (TCGA-KIRC).

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Cardiovascular diseases are a major global health concern, with statin therapy playing a significant role in primary and secondary prevention. Statin-associated muscle symptoms typically occur early in treatment, but severe rhabdomyolysis is a rare complication. We present an unprecedented case of a patient who developed severe rhabdomyolysis with acute kidney injury after 10 years of uninterrupted statin therapy.

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Article Synopsis
  • The study aimed to evaluate the effectiveness of combining arterial embolization with various embolic agents and microwave ablation (MWA) in reducing the size of renal tumor ablation zones in pigs.
  • Researchers conducted experiments on 32 tumors, using different embolic materials before applying MWA, and then assessed the changes in ablation zones through gross and histologic analysis.
  • Results showed that the use of smaller particle sizes for embolization significantly increased the size of the ablation zones compared to MWA alone, with the most effective particle sizes being between 50-150 μm.
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Purpose: The management of renal cell carcinoma (RCC) relies on clinical and histopathological features for treatment decisions. Recently, radiomics, which involves the extraction and analysis of quantitative imaging features, has shown promise in improving RCC management. This review evaluates the current application and limitations of radiomics for predicting treatment and oncological outcomes in RCC.

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SPHK1 (sphingosine kinase type 1) is characterized as a rate-limiting enzyme in sphingolipid metabolism to phosphorylate sphingosine into sphingosine-1-phosphate (S1P) that can bind to S1P receptors (S1PRs) to initiate several signal transductions leading to cell proliferation and survival of normal cell. Many studies have indicated that SPHK1 is involved in several types of cancer development, however, a little is known in bladder cancer. The TCGA database analysis was utilized for analyzing the clinical relevance of SPHK1 in bladder cancer.

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Unlabelled: In this study we evaluated outcomes of patients with metastatic renal cell carcinoma who received immunotherapy before surgery. We found that receiving immunotherapy combinations before surgery can offer patients benefits in reducing tumor size and improving disease control.

Background: Immunotherapy (IO) has improved outcomes for patients with metastatic renal cell carcinoma (mRCC).

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Most kidney cancers are metabolically dysfunctional, but how this dysfunction affects cancer progression in humans is unknown. We infused C-labelled nutrients in over 80 patients with kidney cancer during surgical tumour resection. Labelling from [U-C]glucose varies across subtypes, indicating that the kidney environment alone cannot account for all tumour metabolic reprogramming.

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mTORC1 is aberrantly activated in renal cell carcinoma (RCC) and is targeted by rapalogs. As for other targeted therapies, rapalogs clinical utility is limited by the development of resistance. Resistance often results from target mutation, but mTOR mutations are rarely found in RCC.

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Article Synopsis
  • - The study highlights the lack of effective predictive biomarkers for metastatic clear cell renal cell carcinoma (ccRCC), a cancer treatable by various inhibitors, and introduces the Angioscore as a promising RNA-based measure for predicting response to anti-angiogenic therapies, despite challenges in clinical adoption due to factors like high cost and tumor heterogeneity.
  • - A novel deep learning model is developed to estimate the Angioscore from histopathology slides, providing visualizations of vascular networks, which enhances its interpretability compared to traditional models.
  • - The model demonstrates strong predictive capability, showing high correlation with the Angioscore in multiple cohorts and effectively predicting treatment responses, making it a potentially valuable tool for understanding angiogenesis in ccRCC at a
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Article Synopsis
  • Sarcomatoid dedifferentiation occurs in various renal cell carcinoma subtypes, including chromophobe RCC, leading to more aggressive disease and resistance to treatments, but increased response to immunotherapy.
  • Research on ChRCC reveals that it can dedifferentiate into sarcomatoid, anaplastic, and glandular forms, which are all linked to enhanced aggressiveness and metastasis.
  • Key mutations, like those in TP53 and PTEN, drive this dedifferentiation process, and specific genetic and molecular markers could help classify and diagnose these aggressive tumors more effectively.
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N6-Methyladenosine (m6A) is the most abundant posttranscriptional modification, and its contribution to cancer evolution has recently been appreciated. Renal cancer is the most common adult genitourinary cancer, approximately 85% of which is accounted for by the clear cell renal cell carcinoma (ccRCC) subtype characterized by VHL loss. However, it is unclear whether VHL loss in ccRCC affects m6A patterns.

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The NCCN Guidelines for Kidney Cancer provide multidisciplinary recommendations for diagnostic workup, staging, and treatment of patients with renal cell carcinoma (RCC). These NCCN Guidelines Insights focus on the systemic therapy options for patients with advanced RCC and summarize the new clinical data evaluated by the NCCN panel for the recommended therapies in Version 2.2024 of the NCCN Guidelines for Kidney Cancer.

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Translocation renal cell carcinoma (tRCC) most commonly involves an ASPSCR1-TFE3 fusion, but molecular mechanisms remain elusive and animal models are lacking. Here, we show that human ASPSCR1-TFE3 driven by Pax8-Cre (a credentialed clear cell RCC driver) disrupted nephrogenesis and glomerular development, causing neonatal death, while the clear cell RCC failed driver, Sglt2-Cre, induced aggressive tRCC (as well as alveolar soft part sarcoma) with complete penetrance and short latency. However, in both contexts, ASPSCR1-TFE3 led to characteristic morphological cellular changes, loss of epithelial markers, and an epithelial-mesenchymal transition.

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Sarcomatoid yolk sac tumor is a very rare histologic type of testicular germ cell tumor and is mainly reported in testicular germ cell tumor patients who receive chemotherapy. Herein, we report an extremely rare concurrent retroperitoneal sarcomatoid yolk sac tumor in a man with a testicular postpuberal teratoma before he received chemotherapy. A 37-year-old man initially presented with a persistent abdominal pain.

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Objective: This study aimed to develop a diagnostic model to estimate the distribution of small renal mass (SRM; ≤4 cm) histologic subtypes for patients with different demographic backgrounds and clear cell likelihood score (ccLS) designations.

Materials And Methods: A bi-institution retrospective cohort study was conducted where 347 patients (366 SRMs) underwent magnetic resonance imaging and received a ccLS before pathologic confirmation between June 2016 and November 2021. Age, sex, race, ethnicity, socioeconomic status, body mass index (BMI), and the ccLS were tabulated.

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TANK-binding kinase 1 (TBK1) is a potential therapeutic target in multiple cancers, including clear cell renal cell carcinoma (ccRCC). However, targeting TBK1 in clinical practice is challenging. One approach to overcome this challenge would be to identify an upstream TBK1 regulator that could be targeted therapeutically in cancer specifically.

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In this review, we highlight and contextualize emerging morphologic prognostic and predictive factors in renal cell carcinoma. We focus on clear cell renal cell carcinoma (ccRCC), the most common histologic subtype. Our understanding of the molecular characterization of ccRCC has dramatically improved in the last decade.

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Article Synopsis
  • * Certain fusion partners, like MED15, alter the tumor's appearance, causing it to resemble less harmful cystic tumors.
  • * This text discusses a specific case of MED15::TFE3 RCC in an older adult and offers insights into diagnosing similar low-grade renal tumors effectively.
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Article Synopsis
  • - Recent research has identified a range of renal tumors linked to the TSC/mTOR pathway, including types like renal cell carcinoma with fibromyomatous stroma and eosinophilic solid and cystic renal cell carcinoma.
  • - These tumors often exhibit unique physical and biochemical characteristics that allow for easy identification, reducing the need for detailed molecular testing.
  • - The report highlights the latest findings and the growing complexity in understanding these renal tumor types.
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Purpose: Communication is vital to facilitate patient and family-centred care (PFCC) and to build trusting relationships between intensive care unit (ICU) health care providers, the patient, and their loved ones in the ICU. The focus of this investigation was to identify, define, and refine key moments of communication, connection, and relationship building in the ICU through a lens of Equity, Diversity, Decolonization, and Inclusion (EDDI) to encourage meaningful communication and development of trusting relationships.

Methods: We conducted 13 journey mapping interviews with ICU health care providers, patients, and their loved ones as the first stage in a design thinking project.

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Background: Most renal cell carcinomas (RCCs) are localized and managed by active surveillance, surgery, or minimally invasive techniques. Stereotactic ablative radiation (SAbR) may provide an innovative non-invasive alternative although prospective data are limited.

Objective: To investigate whether SAbR is effective in the management of primary RCCs.

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Most kidney cancers display evidence of metabolic dysfunction but how this relates to cancer progression in humans is unknown. We used a multidisciplinary approach to infuse C-labeled nutrients during surgical tumour resection in over 70 patients with kidney cancer. Labeling from [U-C]glucose varies across cancer subtypes, indicating that the kidney environment alone cannot account for all metabolic reprogramming in these tumours.

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Background: The rapidly evolving pandemic of Coronavirus disease 2019 (COVID-19) has presented with clinical severity, which varies from asymptomatic cases to being fatal in others. The need of the hour is to find meaningful and cost-effective COVID-19 biomarkers out of conventional hematological and biochemical parameters, which will help in the early identification of patients with a poor prognosis, leading to timely intervention.

Aim: The aim was to analyze different biochemical and hematological parameters in COVID-19 patients and also to study the association of these parameters with disease severity.

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Targeting metabolic vulnerabilities has been proposed as a therapeutic strategy in renal cell carcinoma (RCC). Here, we analyzed the metabolism of patient-derived xenografts (tumorgrafts) from diverse subtypes of RCC. Tumorgrafts from -mutant clear cell RCC (ccRCC) retained metabolic features of human ccRCC and engaged in oxidative and reductive glutamine metabolism.

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