Contrast media enhancement reduction predicts tumor response to presurgical molecular-targeting therapy in patients with advanced renal cell carcinoma
| Autor: | Shingo Hatakeyama, Hideaki Hirai, Chikara Ohyama, Yoshimi Tanaka, Kazuhisa Hagiwara, Hiroshi Kijima, Ayumu Kusaka, Yuki Tobisawa, Yasuhiro Hashimoto, Takuya Koie, Tohru Yoneyama, Takahiro Yoneyama, Hayato Yamamoto, Itsuto Hamano, Shogo Hosogoe, Satoko Morohashi |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
renal cell carcinoma medicine.medical_specialty medicine.medical_treatment axitinib 030232 urology & nephrology Urology Contrast Media Antineoplastic Agents Nephrectomy Necrosis 03 medical and health sciences 0302 clinical medicine Renal cell carcinoma Preoperative Care medicine Humans Molecular Targeted Therapy Prospective cohort study Carcinoma Renal Cell Protein Kinase Inhibitors Response Evaluation Criteria in Solid Tumors Aged Neoplasm Staging Everolimus business.industry Sunitinib radiological response Middle Aged medicine.disease Kidney Neoplasms Temsirolimus Surgery Radiographic Image Enhancement Axitinib Treatment Outcome Oncology 030220 oncology & carcinogenesis Female presurgical therapy Tomography X-Ray Computed business Research Paper medicine.drug |
| Zdroj: | Oncotarget |
| ISSN: | 1949-2553 |
| Popis: | // Shogo Hosogoe 1 , Shingo Hatakeyama 1 , Ayumu Kusaka 1 , Itsuto Hamano 1 , Yoshimi Tanaka 1 , Kazuhisa Hagiwara 1 , Hideaki Hirai 2 , Satoko Morohashi 2 , Hiroshi Kijima 2 , Hayato Yamamoto 1 , Yuki Tobisawa 1 , Tohru Yoneyama 3 , Takahiro Yoneyama 1 , Yasuhiro Hashimoto 3 , Takuya Koie 1 and Chikara Ohyama 1, 3 1 Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan 2 Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Japan 3 Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan Correspondence to: Shingo Hatakeyama, email: shingoh@hirosaki-u.ac.jp Keywords: renal cell carcinoma, presurgical therapy, axitinib, radiological response Received: March 29, 2017 Accepted: May 04, 2017 Published: May 17, 2017 ABSTRACT Background and Objective: A quantitative tumor response evaluation to molecular-targeting agents in advanced renal cell carcinoma (RCC) is debatable. We aimed to evaluate the relationship between radiologic tumor response and pathological response in patients with advanced RCC who underwent presurgical therapy. Results: Of 34 patients, 31 underwent scheduled radical nephrectomy. Presurgical therapy agents included axitinib ( n = 26), everolimus ( n = 3), sunitinib ( n = 1), and axitinib followed by temsirolimus ( n = 1). The major presurgical treatment-related adverse event was grade 2 or 3 hypertension (44%). The median radiologic tumor response by RECIST, Choi, and CMER were −19%, −24%, and −49%, respectively. Among the radiologic tumor response tests, CMER showed a higher association with tumor necrosis in surgical specimens than others. Ki67/MIB1 status was significantly decreased in surgical specimens than in biopsy specimens. The magnitude of the slope of the regression line associated with the tumor necrosis percentage was greater in CMER than in Choi and RECIST. Materials and Methods: Between March 2012 and December 2016, we prospectively enrolled 34 locally advanced and/or metastatic RCC who underwent presurgical molecular-targeting therapy followed by radical nephrectomy. Primary endpoint was comparison of radiologic tumor response among Response Evaluation Criteria in Solid Tumors (RECIST), Choi, and contrast media enhancement reduction (CMER). Secondary endpoint included pathological downstaging, treatment related adverse events, postoperative complications, Ki67/MIB1 status, and tumor necrosis. Conclusions: CMER may predict tumor response after presurgical molecular-targeting therapy. Larger prospective studies are needed to develop an optimal tumor response evaluation for molecular-targeting therapy. |
| Databáze: | OpenAIRE |
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