Multicenter retrospective analysis of FOLH1 expression in renal cell carcinoma and impact on outcomes

While treatments have expanded for advanced renal cell carcinoma (RCC), resistance emerges in the majority of patients. Prostate membrane-specific antigen (PSMA) diagnostic and therapeutic strategies have emerged, and early studies highlight the relevance of PSMA in RCC tumors. These early observations have generated interest in targeting PSMA, which is encoded by the FOLH1 gene, as a diagnostic and therapeutic strategy in RCC. A multicenter retrospective study in the USA investigated patterns of FOLH1 expression in RCC and their impact on outcomes. The study found differential FOLH1 expression based on RCC histology and metastatic sites. There was a correlation between FOLH1 expression and an angiogenic gene signature, suggesting potential therapeutic implications for tumors with high FOLH1 expression. High FOLH1 expression was associated with an increased time on cabozantinib and increased overall survival. The authors conclude that the study provides insights for designing diagnostic and therapeutic strategies that target FOLH1/PSMA.