Ribback S, Winter S, Klatte T, et al. - In clear cell renal cell carcinoma (ccRCC), Trx1 (thioredoxin1) may play a role in the tumor biology, and therefore, in depth investigations of redox signaling pathways in ccRCC are robustly supported.

• Thioredoxins are major regulatory proteins of oxidative signaling.

• Prognostic role of Trx1 in ccRCC was assessed, via a tissue micro-array (TMA) study and using data from the Cancer Genome Atlas (TCGA).

• Lower T stages, less often distant metastases, lower nuclear grades, and less often tumor necrosis or sarcomatoid features were seen in ccRCC patients in the TMA.

• Better disease-specific survival was observed in patients with a combined score of  ≥ 10 vs a low combined score of < 10 (HR 0.62).

• The worst survival outcome (HR 3.1) was noted in ccRCC patients whose tumors had exclusively Trx1 expression in the cytoplasm.

• Genomic data showed more advanced clinicopathological features and worse survival outcome in disease specific, overall, and progression free survival in patients with Trx1 losses vs those without copy number variations or gains.