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Kidney Cancer Biomarkers

Reviewed by XpertPatient Medical Advisory  ·  Updated August 2026  ·  Primary Source: cancer.gov

Start Here

What Is a Biomarker — and Why Does It Matter for Your Treatment?

A biomarker is a signal found in your tumor or blood. In kidney cancer, the most important biomarker is a gene called VHL — when it is lost, it triggers a chain of events that targeted approaches are designed to stop.

Think of it like a clue. Your doctor collects clues from your biomarker test results. Those clues help build a picture of your cancer. That picture helps you have a more informed conversation with your care team about next steps.

How a Biomarker Test Works

Your Tumor leaves behind signals Biopsy or Blood Test VHL loss PD-L1+ IMDC: low Your Results Your Doctor Chooses the approach most likely to work for your specific tumor

A biomarker is a signal your cancer leaves behind. Your doctor finds it through a biopsy or blood test, reads your results, and uses them to choose the treatment most likely to work for your specific tumor.

Why Do Biomarkers Matter in Kidney Cancer?

Standard chemotherapy does not work well for kidney cancer. Targeted drugs and immunotherapy are the standard. Biomarker testing helps your doctor choose the right combination for your situation.

The most important kidney cancer biomarkers are VHL gene status and PD-L1 expression. Together they help your doctor choose the treatment combination most likely to work for you.

A good question to ask your doctor: Ask your doctor what your risk category is and how your biomarker results fit into your care plan.

Quick Poll

Have you been biomarker tested?

VHL status and IMDC risk score are the key starting points for understanding your kidney cancer treatment options.

How others answered

Yes
0%
No
0%
Not sure
0%

Source: DaCosta Byfield et al., JAMA Network Open, July 2025  ·  overall advanced cancer biomarker testing rate (n=26,311)  ·  jamanetwork.com

The Tests Your Doctor May Order

VHL VHL Gene

Is the main brake gene missing from your cancer cells?

VHL loss is found in most clear cell kidney cancers. When VHL is lost, the cancer sends signals to grow new blood vessels. Targeted drugs work by blocking those signals. Ask your doctor what VHL status means for your care.

PD-L1 PD-L1

Can immunotherapy activate your immune system?

PD-L1 testing helps your doctor choose between immunotherapy options. Several immunotherapy combinations are now standard first-line care for advanced kidney cancer. Ask your doctor what your PD-L1 result means.

IMDC IMDC Risk Score

What is your overall risk category?

The IMDC score uses six simple health measures to place you in a low, medium, or high risk group. Your risk group is one of the main factors your doctor uses to recommend your first treatment. Ask your doctor what your IMDC risk category is.

Sources: National Cancer Institute  ·  Kidney Cancer Association  ·  American Cancer Society

Common Questions

Kidney Cancer Biomarkers — Your Questions Answered

Does kidney cancer respond to chemotherapy?

Standard chemotherapy does not work well for kidney cancer. Targeted drugs and immunotherapy are the standard approaches. Ask your care team what options make sense for your situation.

What is the IMDC risk score?

A score based on six simple health measures that classifies your risk. Your risk category helps your doctor choose your first treatment.

What if I have a less common type of kidney cancer?

About 20 to 25% of kidney cancers are non-clear cell types. Ask your doctor to confirm your exact tumor type and what that means for your care.

Can biomarker testing help me find a clinical trial?

Yes. Ask your doctor about comprehensive testing or visit clinicaltrials.gov.

Knowledge Check

Test what you’ve learned

Three quick questions to help you feel more confident talking with your care team.

Why doesn’t chemotherapy work well for kidney cancer?

Based on what you just read, what are the main treatment approaches for kidney cancer?

What does the VHL gene do?

Based on what you just read, what happens when VHL is lost from cancer cells?

What is the IMDC score?

Based on what you just read, what does the IMDC score measure?

Keep these in mind for your next appointment.

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