b'Redefining Research & CareRedefininggoes by and additional scans are obtained.First Ablation Program in Texas Research at the Kidney Cancer Program is changing the playing field. InvestigatorsWhen tumors require intervention, Research & Care have developed tools to determine todayradiofrequency ablation is one option.how tumors will behave. With SPORE funding, urological sur- In 2000, UT Southwestern urologist geons Drs. Cadeddu and Vitaly MargulisDr. Cadeddu was the first in Texas (and one have teamed up with biochemist Dr. Ralphof the first in the U.S.) to perform an abla-At Simmons Cancer Center, kidney cancer leaders harness theDeBerardinis and medical oncologistTo assess tumor aggressiveness and predicttion for kidney cancer. Today, after having latest discoveries and innovation, translating breakthroughs intoDr. Kevin Courtney to find the answer. Theirfuture behavior, a team of investigators withtreated more than 400 patients, the kidney support from the SPORE is measuring nutrient new approaches that benefit patients. approach: to determine which tumors areintake by tumors. tumor ablation program has become the hungry. Rapidly growing tumors need tomost experienced in the region. beef up with extra nutrients to fuel theirand NMR spectroscopy, available at justAt UT Southwestern, some 30 to 40 growth. By measuring the tumors nutrienta few centers around the world, the teamkidney cancer patients are treated with RFAintake, doctors believe they will be able tostudies tumor metabolismhow the tumor(radiofrequency ablation) per year. Guided Innovations for predict which tumors are aggressive andprocesses nutrients to fuel its growth.by ultrasound or CT scans, surgeons insert Small Kidney Tumors should be removed. Using avant-garde(Zhang et al., JCI Insight, 2017; Courtney eta long, thin probe through the skin. The techniques such as stable isotope infusionsal., Cell Metab, 2018)probe applies high-energy radio waves to In many cases, this presents a dilemma:Physician-scientists at UT Southwestern Some kidney tumors grow slowly Is the mass a benign tumor, a cancer thathave developed a new approach that can and wont cause problems. urgently requires surgery, or a cancer thatevaluate kidney tumors and spare patients The question is, which ones?can simply be watched?the biopsy.To determine how dangerous a can-Among newly found kidney tumors, nearlycer may be, a sample of the tumor canBreakthrough: New MRI technology half are small renal massesmeasuringbe obtained through a biopsy. However,bypasses need for biopsiesless than 1.5 inches (or 4 cm). These can- sometimes biopsies are not informative orUsing a state-of-the-art technique, mpMRI cers are often detected by happenstancesimply cannot be performed because the(multiparametric magnetic resonance on scans to evaluate other conditions. location of the tumor makes them unsafe.imaging), Drs. Ivan Pedrosa and Jeffrey Cadeddu have developed a protocol to predict whether a small tumor is a clear cell renal cell carcinoma (ccRCC), an aggressive type. The study involved more than 100 patients with small kidney tumors who underwent an mpMRI before they had surgery. Seven expert radiologists reviewed the images. By comparison to microscopic analyses after tumors had been removed, the radiologists correctly predicted whether a tumor was RCC (renal cell cancer) 80 per-cent of the time. An MRI-based formula has now been incorporated into clinical practice at the Kidney Cancer Program to help doc-tors determine whether a tumor is clear cell RCC. (Canvasser et al., J Urol, 2017; Kay et al., Radiology, 2018) Challenge: Which Small Tumors Dr. Ralph DeBerardinis, an investigator with the Require Intervention?Howard Hughes Medical Of course, those that grow. But to knowInstitute and a leader in cancer metabolism, Dr. Ivan Pedrosa, Chief ofwhether a tumor is growing, its behaviorevaluates how kidney MRI, reviewing a case. needs to be observed over time, whichcancers use nutrients.means patients have to wait until time 28 29'