Giuseppe Lucarelli, Francesco Lasorsa, Martina Milella, Antonio d’Amati, G. Ingravallo, Antonio Di Bari, Savio Domenico Pandolfo, Roberto Tamma, Michela De Giorgis, Domenico Ribatti, Annalisa Schirinzi, Francesca Di Serio, Alessandro Caniglia, Zito Fa, Emanuele Naglieri, Michele Battaglia, Pasquale Ditonno, Monica Rutigliano
Clear cell renal carcinoma (ccRCC) is a prevalent kidney cancer with limited effective biomarkers for prognosis and treatment guidance. Despite advancements, a significant portion of ccRCC cases progress to advanced stages, necessitating novel diagnostic tools. Here, we investigated the expression of MUC1 and its soluble form, CA15-3, in ccRCC, evaluating their potential as biomarkers for angiogenesis and response to sunitinib therapy. Molecular analyses showed that MUC1 expression was associated with angiogenesis, epithelial-mesenchymal transition, hypoxia/metabolism regulation, and complement system activation. In particular MUC1 overexpression correlated with increased microvascular density in vitro and in vivo models. Elevated CA15-3 levels were associated with tumor burden and predict clinical response to sunitinib in metastatic ccRCC. Metabolomic analysis showed that sunitinib-responding tumors were characterized by specific metabolic changes involving glucose and lipid metabolism, in association with impaired oxidative phosphorylation. MUC1 expressing ccRCC is a high angiogenic tumor that presents characteristics of increased aggressiveness, and a specific metabolic profile. Serum CA15-3 is a marker of poor survival and predicts response of sunitinib in patients with metastatic disease.