Proteomics and the search for biomarkers for renal cancer.

Worldwide, over 273,000 people are diagnosed with renal cancer each year. Approximately one third of patients present with locally advanced or metastatic disease and although surgery is largely curative in those with localised disease, about one third of these patients will subsequently relapse. Renal cancer is resistant to conventional chemotherapy and radiotherapy but increased understanding of the underlying tumour biology is leading to the use and development of targeted therapies, such as tyrosine kinase inhibitors targeting pathways downstream of the von Hippel Lindau tumour suppressor gene. There are no biomarkers in routine clinical use in renal cancer but they are urgently needed for enabling earlier diagnosis, differential diagnosis of histological subtypes and their variants, risk stratification to allow personalised follow-up and prediction and monitoring of response and toxicity to targeted therapies. Several groups are now applying proteomic strategies in biomarker discovery in renal cancer. We review the progress being made in these studies and discuss the strategies needed to ensure effective translation of findings to the clinic.