Volumetric FDG-PET predicts overall and progression- free survival after 14 days of targeted therapy in metastatic renal cell carcinoma

BMC Cancer

Jacob Farnebo³  Per Grybäck³  Ulrika Harmenberg²  Anna Laurell¹  Peter Wersäll²  Lennart K Blomqvist³  Anders Ullén²  Per Sandström² 

[1] Department of Oncology, Academic Hospital, Uppsala, Sweden

[2] Department of Oncology, Karolinska University Hospital and Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden

[3] Department of Diagnostic Radiology, Karolinska University Hospital and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

关键词: Total lesion glycolysis;    Targeted therapy;    Biomarker;    Renal cell carcinoma;    FDG-PET;   

Others  :  858699
DOI  :  10.1186/1471-2407-14-408

 received in 2014-03-04, accepted in 2014-06-02,  发布年份 2014

【 摘 要 】

Background

To determine whether changes in the metabolism of metastatic renal cell carcinoma (mRCC) assessed by F18-FDG-PET after 14 and 28 days of treatment with tyrosine kinase inhibitors can predict overall and progression- free patient survival.

Methods

Thirty-nine consecutive patients with mRCC were included prospectively and underwent PET examinations prior to and after 14 and 28 days of standard treatment with sunitinib (n = 18), sorafenib (n = 19) or pazopanib (n = 2). The PET response was analyzed in terms of SUVmax, SULpeak, and total lesion glycolysis and a positive response (defined as a 30% reduction) compared to overall and progression- free survival.

Results

Thirty-five patients with at least one metabolically active metastatic lesion prior to treatment underwent additional FDG-PET examinations after 14 (n = 32) and/or 28 days (n = 30) of treatment. Changes in either SULpeak or total lesion glycolysis were correlated to both progression-free and overall survival (for TLG2.5 responders, HR = 0.38 (95% CI: 0.18-0.83) and 0.22 (95% CI: 0.09-0.53), and for TLG50 responders, HR = 0.25 (0.10-0.62) and 0.25 (95% CI: 0.11-0.57) and for SULpeak responders, HR = 0.39 (95% CI: 0.17-0.91) and 0.38 (95% CI: 0.15-0.93), respectively). In contrast SUVmax response did not predict progression- free or overall survival (HR = 0.43 (95% CI: 0.18-1.01) and 0.50 (95% CI: 0.21-1.19), respectively).

Conclusions

Assessment of early changes in SULpeak and total lesion glycolysis undergoing treatment with tyrosine kinase inhibitors by FDG-PET can possibly predict progression- free and overall survival in patients with mRCC.

【 授权许可】

   
2014 Farnebo et al.; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]Escudier B, Eisen T, Stadler WM, Szczylik C, Oudard S, Siebels M, Negrier S, Chevreau C, Solska E, Desai AA, Rolland F, Demkow T, Hutson TE, Gore M, Freeman S, Schwartz B, Shan M, Simantov R, Bukowski RM, TARGET Study Group: Sorafenib in advanced clear-cell renal-cell carcinoma. N Engl J Med 2007, 356(2):125-134.
• [2]Motzer RJ, Hutson TE, Tomczak P, Michaelson MD, Bukowski RM, Rixe O, Oudard S, Negrier S, Szczylik C, Kim ST, Chen I, Bycott PW, Baum CM, Figlin RA: Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med 2007, 356(2):115-124.
• [3]Sternberg CN, Davis ID, Mardiak J, Szczylik C, Lee E, Wagstaff J, Barrios CH, Salman P, Gladkov OA, Kavina A, Zarbá JJ, Chen M, McCann L, Pandite L, Roychowdhury DF, Hawkins RE: Pazopanib in locally advanced or metastatic renal cell carcinoma: results of a randomized phase III trial. J Clin Oncol 2010, 28(6):1061-1068.
• [4]van Cruijsen H, van der Veldt A, Hoekman K: Tyrosine kinase inhibitors of VEGF receptors: clinical issues and remaining questions. Front Bioscie 2009, 14:2248-2268.
• [5]Treglia G, Mirk P, Stefanelli A, Rufini V, Giordano A, Bonomo L: 18 F-Fluorodeoxyglucose positron emission tomography in evaluating treatment response to imatinib or other drugs in gastrointestinal stromal tumors: a systematic review. Clin Imaging 2012, 36(3):167-175.
• [6]Ueno D, Yao M, Tateishi U, Minamimoto R, Makiyama K, Hayashi N, Sano F, Murakami T, Kishida T, Miura T, Kobayashi K, Noguchi S, Ikeda I, Ohgo Y, Inoue T, Kubota Y, Nakaigawa N: Early assessment by FDG-PET/CT of patients with advanced renal cell carcinoma treated with tyrosine kinase inhibitors is predictive of disease course. BMC Cancer 2012, 12:162. BioMed Central Full Text
• [7]Kayani I, Avril N, Bomanji J, Chowdhury S, Rockall A, Sahdev A, Nathan P, Wilson P, Shamash J, Sharpe K, Lim L, Dickson J, Ell P, Reynolds A, Powles T: Sequential FDG-PET/CT as a biomarker of response to Sunitinib in metastatic clear cell renal cancer. Clin Cancer Res 2011, 17(18):6021-6028.
• [8]Hatt M, Groheux D, Martineau A, Espie M, Hindie E, Giacchetti S, de Roquancourt A, Visvikis D, Cheze-Le Rest C: Comparison between 18 F-FDG PET image-derived indices for early prediction of response to neoadjuvant chemotherapy in breast cancer. J Nucl Med 2013, 54(3):341-349.
• [9]Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J: New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009, 45(2):228-247.
• [10]Wahl RL, Jacene H, Kasamon Y, Lodge MA: From RECIST to PERCIST: evolving Considerations for PET response criteria in solid tumors. J Nucl Med 2009, 50(Suppl 1):122S-150S.
• [11]Heng DY, Xie W, Regan MM, Warren MA, Golshayan AR, Sahi C, Eigl BJ, Ruether JD, Cheng T, North S, Venner P, Knox JJ, Chi KN, Kollmannsberger C, McDermott DF, Oh WK, Atkins MB, Bukowski RM, Rini BI, Choueiri TK: Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study. J Clin Oncol 2009, 27(34):5794-5799.
• [12]Lyrdal D, Boijsen M, Suurkula M, Lundstam S, Stierner U: Evaluation of sorafenib treatment in metastatic renal cell carcinoma with 2-fluoro-2-deoxyglucose positron emission tomography and computed tomography. Nucl Med Commun 2009, 30(7):519-524.
• [13]Vercellino L, Bousquet G, Baillet G, Barre E, Mathieu O, Just PA, Desgrandchamps F, Misset JL, Hindie E, Moretti JL: 18 F-FDG PET/CT imaging for an early assessment of response to sunitinib in metastatic renal carcinoma: preliminary study. Cancer Biother Radiopharm 2009, 24(1):137-144.
• [14]Kumar V, Nath K, Berman CG, Kim J, Tanvetyanon T, Chiappori AA, Gatenby RA, Gillies RJ, Eikman EA: Variance of SUVs for FDG-PET/CT is greater in clinical practice than under ideal study settings. Clin Nucl Med 2013, 38(3):175-182.
• [15]Vanderhoek M, Perlman SB, Jeraj R: Impact of the definition of peak standardized uptake value on quantification of treatment response. J Nucl Med 2012, 53(1):4-11.
• [16]Haioun C, Itti E, Rahmouni A, Brice P, Rain JD, Belhadj K, Gaulard P, Garderet L, Lepage E, Reyes F, Meignan M: [18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in aggressive lymphoma: an early prognostic tool for predicting patient outcome. Blood 2005, 106(4):1376-1381.
• [17]Hutchings M, Mikhaeel NG, Fields PA, Nunan T, Timothy AR: Prognostic value of interim FDG-PET after two or three cycles of chemotherapy in Hodgkin lymphoma. Annals Oncol 2005, 16(7):1160-1168.
• [18]Jager PL, Gietema JA, van der Graaf WT: Imatinib mesylate for the treatment of gastrointestinal stromal tumours: best monitored with FDG PET. Nucl Med Commun 2004, 25(5):433-438.
• [19]Lassau N, Koscielny S, Albiges L, Chami L, Benatsou B, Chebil M, Roche A, Escudier BJ: Metastatic renal cell carcinoma treated with sunitinib: early evaluation of treatment response using dynamic contrast-enhanced ultrasonography. Clin Cancer Res 2010, 16(4):1216-1225.
• [20]Young H, Baum R, Cremerius U, Herholz K, Hoekstra O, Lammertsma AA, Pruim J, Price P: Measurement of clinical and subclinical tumour response using [18F]-fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group. Eur J Cancer 1999, 35(13):1773-1782.