This $927,997 Project Grant awarded by the National Cancer Institute (CFDA 93.394 - Cancer Detection and Diagnosis Research) aims to develop a prognostic assay for accurately predicting metastasis in clear cell renal cell carcinoma (CCRCC) patients. The funding will enable the awardee, Lagrange Scientific LLC, to further refine and validate a prototype 12-marker metabolomic panel that can identify CCRCC patients at high risk of progressing to metastasis, up to 4.6 years earlier than the current standard of care. Pilot studies have demonstrated 100% specificity and 83% sensitivity in predicting metastasis using this panel. The project will leverage tumor biorepositories from multiple research institutions to prospectively collect and analyze CCRCC tissue samples, with the goal of commercializing this novel diagnostic tool to stratify aggressive CCRCC subtypes and guide earlier initiation of systemic therapy for high-risk patients.