Urine test shows promise in reducing post-op kidney cancer scans by half
A new urine test could reduce the need for routine CT scans after kidney cancer surgery by reliably ruling out recurrence, early results from a major international study show.
A non-invasive urine test may soon transform how patients are monitored following surgery for clear cell renal cell carcinoma (ccRCC)—the most common form of kidney cancer. The findings, presented at the EAU25 Congress in Madrid and accepted for publication in European Urology Oncology, show that the test could safely reduce the number of post-operative scans by half.
How the GAGome test works
The test works by analysing glycosaminoglycans (GAGs)—a type of sugar molecule found in urine. These molecular profiles, referred to as the GAGome, are measured and assigned a score that can indicate whether the cancer has returned.
Initial results from the AURORAX-0087A (AUR87A) study, which includes patients across Europe and North America, show the GAGome test correctly identified 90% of patients with a recurrence, and ruled out cancer in 97% of those who remained disease-free. These results suggest the test has comparable accuracy to CT scans, which are currently the gold standard for monitoring recurrence.
“CT scans often pick up small findings we can’t yet interpret, which can lead to unnecessary stress and extra follow-ups,” said Assoc. Prof. Saeed Dabestani (Lund University, Sweden), the study’s lead investigator. “If we can reliably use a urine test to rule out recurrence, then we could safely reduce scan frequency—potentially cutting the number of scans in half.”
The first study cohort involved 134 patients with non-metastatic ccRCC treated with surgery at 23 centres in the UK, EU, USA, and Canada. All patients continued regular CT scans while also providing a urine sample every three months. Samples were scored using mass spectrometry, with a score above 12 considered a positive result. A positive test gave a 26% chance of actual recurrence, while a negative score came with a 97% certainty of no recurrence.
Expert insights
The test's high negative predictive value is especially promising, says Dr Carmen Mir Maresma (University Hospitals La Ribera, Spain), a member of the EAU Scientific Congress Office. “If the test comes back negative, you can be fairly confident the cancer hasn’t returned. That could be hugely beneficial in reassuring patients and reducing unnecessary imaging.”
The study is still ongoing, with a second patient cohort currently being recruited to validate the results. Final data from this next phase are expected later in 2025. The test itself, developed by Swedish diagnostics company Elypta, is not yet approved for clinical use and will require further validation before widespread implementation.
As new treatments like immunotherapy (e.g., pembrolizumab) are increasingly used after surgery, researchers also aim to explore how this urine-based biomarker may interact with evolving therapeutic strategies.