Characterization of IFOLH1/I Expression in Renal Cell Carcinoma

While treatments have expanded for advanced renal cell carcinoma (RCC), resistance emerges in the majority of patients. Novel alternative diagnostics and therapeutics are required to improve outcomes. 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. We aimed to investigate patterns of FOLH1 expression in RCC and their impact on outcomes. We identified differential FOLH1 expression based on RCC histology and metastatic sites. We observed a correlation between FOLH1 expression and an angiogenic gene signature, suggesting potential therapeutic implications for tumors with high FOLH1 expression. Consistent with our findings, high FOLH1 expression was associated with an increased time on cabozantinib. Ultimately, this analysis provides insights for designing diagnostic and therapeutic strategies that target FOLH1/PSMA. Purpose: Given the emergence of PSMA-targeted diagnostic agents and therapeutics, we sought to investigate patterns of FOLH1 expression in RCC and their impacts on RCC outcomes. Methods: We conducted a pooled multi-institutional analysis of patients with RCC having undergone DNA and RNA next-generation sequencing. FOLH1-high/low expression was defined as the ≥75th/