The human body has a rhythm made up of a series of routines that our cells, organs, and tissues follow. But in 2019, 35-year-old Lamar Valentina discovered that deep inside his kidneys, small, abnormal cells were working at their own pace.
“A pain in my lower back finally became so severe that I had to go to the emergency room,” Valentina says. “I thought I had a sports-related injury, but it was cancer.”
A physically active Air Force recruiter with no family history of cancer in his family, Valentina was shocked. Upon further testing, he learned he had renal medullary carcinoma — an extremely rare and aggressive type of kidney cancer.
Renal medullary carcinoma (RMC) affects fewer than one of every 100 people and makes up less than 1% of all kidney cancers worldwide. The disease is primarily found in young African Americans who have inherited the sickle cell trait in their genes. Valentina discovered he carries the sickle cell trait.
“RMC will often spread even when the tumors in the kidney are very small, so it tends to be a very aggressive cancer with potential to spread very early in the disease course,” says Bradley McGregor, MD, director of clinical research for the Lank Center of Genitourinary Oncology at Dana-Farber Cancer Institute and Valentina’s oncologist. “This kind of kidney cancer does not follow any of the rules.”
Swollen lymph nodes, abdominal pain, and blood in urine are commonly the first signs of this type of rare kidney cancer, but there can be no symptoms at all, making this cancer sneaky. Many individuals are diagnosed at stage IV.
Treatment and searching for answers
Valentina was diagnosed in New York during the peak of the COVID-19 pandemic and moved to Boston for about a year to ensure he receives uninterrupted, specialized treatment with Dana-Farber, and be closer to his son. By the time Valentina sought treatment with McGregor, his cancer had metastasized beyond his kidneys to his lungs and abdomen.
Valentina began chemotherapy and then underwent surgery.
“This all happened so fast and it became very overwhelming,” Valentina says. “But what’s pretty cool is everything happened the way it was supposed to be. I easily bonded with Dr. McGregor over our shared experience in the Air Force, and the good thing is I listened to my body. I started treatment as fast as I could with the best team.”
The standard treatment for renal medullary carcinoma was effective: Valentina’s tumors shrunk though the response did not last and he subsequently went onto three different systemic therapies with the most recent therapy offering prolonged response.
However, finding new treatments for this cancer has remained a challenge for physician-scientists.
“While Lamar responded well to treatment, there are still patients with renal medullary carcinoma that we’re constantly working to help ensure they can enjoy a great response,” McGregor says.
Investigating potential therapeutics
Since Valentina’s diagnosis and treatment, physician-scientists have worked to better map out how rare genetic mutations influence certain proteins on cells that are linked with cancer. Renal medullary carcinoma-driven tumors can express proteins: carcinoembryonic antigen (CEA) and mucin 16 (MUC16) that can serve as cancer biomarkers when they produce higher amounts of them. More recently, tyrosinase-related protein 2 (TROP-2), another protein associated with cancer, has been identified to be associated within the cells of renal medullary carcinoma.
The overexpression of TROP-2 is also associated with other kidney cancers such as papillary RCC (pRCC), one of the most common types of renal cell carcinoma. “Many researchers have investigated it to understand what we might offer patients,” McGregor says.
Researchers are exploring sacituzumab govitecan, a TROP2-targeted antibody-drug conjugate (ADC), as a potential therapeutic. Antibody-drug conjugates are targeted agents that package cancer drugs for special delivery to tumor cells to eliminate them. Novel Dana-Farber research has found sacituzumab govitecan, along with immunotherapy, can target TROP2 and deliver chemotherapy to cancer cells.
While further evaluation of this therapy for renal medullary carcinoma is needed, McGregor is collaborating with other researchers to improve outcomes in RMC as well as other rare types of kidney cancer.
“Our pathologists now provide significantly more information than they did five years ago, and it is up to us to learn how to use it,” McGregor says. “We are making progress with genetically driven trials and phase three efforts. I am optimistic about where this is heading.”
Restoring in remission
Now in remission, 41-year-old Valentina continues to travel to Dana-Farber for his three-month screenings — something that he feels fortunate to do.
“I’ve been able to enjoy time with my son and guide him through his senior year of high school, and support his next step in life,” Valentina says. “Since my diagnosis, l’ve completed my bachelor’s degree in organizational leadership from Arizona State University in 2021 and later completed my master’s in leadership and management in 2025, so l’ve been able to continue to advance my career.”
When Valentina was first diagnosed and began treatment, he was about 15 years into his career. Now, he’s nearing 20 years and is working toward his project management professional certification.
“I’m exploring my next opportunities in life. There is so much more I can do post-treatment and using my military career,” Valentina says. “I think anyone with cancer can relate to my belief that it changes your perspective. It ignited something in me.”
Having visited more than 15 countries from Japan to Colombia, Valentina says he continues to live a creative, purposeful life.
“With or without cancer, life is short,” Valentina says. “Just like Dr. McGregor and the team at Dana-Farber helped me, I want to pass the torch forward.”
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