Obesity is a well-known risk factor for renal cell carcinoma (RCC) development. However, the RCC-obesity link has not been fully addressed when considering a comprehensive scenario starting from pathogenetic aspects through pathological issues up to the outcome of medical treatment. We therefore conducted an electronic PubMed search using keywords "obesity", "body mass index", "overweight", "renal cell carcinoma/kidney cancer", "medical treatment", "targeted therapy", and "immunotherapy/immune checkpoint inhibitors". The selected data supported a crosstalk between adipose tissue (adipocytes and other white adipose tissue cells) and cancer cells inducing several signaling pathways that finally stimulated angiogenesis, survival, and cellular proliferation. Accurate sampling of renal sinus fat correlated with a prognostic value. Retrospective clinical evidence in metastatic RCC patients with higher body mass index (BMI) and treated with targeted therapies and/or immune checkpoint inhibitors showed advantageous survival outcomes. Therefore, obesity may influence the course of RCC patients, although the interplay between obesity/BMI and RCC warrants a large prospective confirmation. We are therefore still far from determining a clear role of obesity as a prognostic/predictive factor in metastatic RCC patients undergoing targeted therapy and immunotherapy.
International journal of molecular sciences. 2019 Nov 13*** epublish ***
Gaetano Aurilio, Francesco Piva, Matteo Santoni, Alessia Cimadamore, Giulia Sorgentoni, Antonio Lopez-Beltran, Liang Cheng, Nicola Battelli, Franco Nolè, Rodolfo Montironi
Medical Division of Urogenital and Head & Neck Cancer, European Institute of Oncology IRCCS, 20141 Milan, Italy., Department of Specialistic Clinical and Odontostomatological Sciences, Polytechnic University of Marche, 60126 Ancona, Italy., Oncology Unit, Macerata Hospital, via Santa Lucia 2, 62010 Macerata, Italy., Section of Pathological Anatomy, United Hospitals, School of Medicine, Polytechnic University of the Marche Region, 60126 Ancona, Italy., Department of Pathology and Surgery, Faculty of Medicine, 14080 Cordoba, Spain., Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.