Dynamic Contrast-Enhanced Computed Tomography as a Potential Biomarker in Patients With Metastatic Renal Cell Carcinoma
| Autor: | Erik Morre Pedersen, Frede Donskov, Finn Rasmussen, Jill Rachel Mains, Hans Henrik Torp Madsen |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Percentile Bevacizumab Imaging biomarker Contrast Media Blood volume Renal cell carcinoma medicine Humans Single-Blind Method Radiology Nuclear Medicine and imaging Prospective Studies Carcinoma Renal Cell Aged business.industry General Medicine Middle Aged medicine.disease Kidney Neoplasms Log-rank test Quartile Biomarker (medicine) Female Tomography X-Ray Computed Nuclear medicine business Biomarkers medicine.drug |
| Zdroj: | Mains, J R, Donskov, F, Pedersen, E M, Madsen, H H T & Rasmussen, F 2014, ' Dynamic contrast-enhanced computed tomography as a potential biomarker in patients with metastatic renal cell carcinoma: preliminary results from the Danish Renal Cancer Group Study-1 ', Investigative Radiology, vol. 49, no. 9, pp. 601-7 . https://doi.org/10.1097/RLI.0000000000000058 |
| ISSN: | 0020-9996 |
| DOI: | 10.1097/rli.0000000000000058 |
| Popis: | Objectives: The aim of this study was to explore the impact of dynamiccontrast-enhanced (DCE) computer tomography (CT) as a biomarker in met-astatic renal cell carcinoma (mRCC).Materials and Methods: Twelve patients with favorable or intermediateMemorial Sloan Kettering Cancer Center risk group and clear cell mRCCparticipating in an ongoing prospective randomized phase II trial comprisinginterleukin-2-based immunotherapy and bevacizumab were included in thispreliminary analysis. All patients had a follow-up time of at least 2 years.Interpretation of DCE-CT (max slope method) was performed blinded to treat-ment group. The DCE-CT scanswere performed atbaseline, atweeks 5 and 10,and thereafter every third month. Blood flow (BF; mL/min/100 mL), peakenhancement (Hounsfield units), time to peak (seconds), and blood volume(BV; mL/100 g) were calculated. Parameters for DCE-CTwere correlated withsumofdiameters(definedbyResponseEvaluationCriteriainSolidTumors1.1),progression-free survival (PFS), and overall survival (OS) using Wilcoxon,Man-Whitney, Kaplan-Meier, and log rank statistics, as appropriate.Results: Blood flow at baseline ranged from 4.9 to 148.1 mL/min/100 mL(median, 62.2; 25th percentile, 25.8; 75th percentile, 110.0). Patients withhigh baseline BF (using quartiles as cutoffs) had significantly longer OS (notreachedvs 5.2months,P = 0.011) and longerPFS(not reached vs3.9 months,P = 0.026). Blood volume at baseline ranged from 8.8 to 74.1 mL/100 g tissue(median, 21.5), and at week 5, from 4.9 to 34.7 mL/100 g (median, 17.2). Rel-ative changes in BV between baseline and week 5 ranged from j64% to +68%(median, j16%; 25th percentile, j41%; 75th percentile, +2%) and were sig-nificantly associated with OS using quartiles as cutoffs (5.2 months vs notreached, P = 0.038) and PFS using the median as cutoff (5.3 months vs notreached, P=0.009),withlargerreductionsassociatedwithlongersurvival.Usingmedians as cutoffs, relative changes in both BF and BV between baseline andweek 10 were significantly associated with OS (for both, 8.6 months vs notreached, P = 0.031).Conclusions: Dynamiccontrast-enhancedCTisapotentialbiomarkerinpatientswith mRCC. High baseline BF and reductions in BF and BV during early treat-ment are associated with improved outcome. Large-scale studies are required.Key Words: imaging biomarker, response assessment, DCE-CT,renal cell carcinoma(Invest Radiol 2014;00: 00Y00) |
| Databáze: | OpenAIRE |
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