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- Title
The radiogenomic risk score stratifies outcomes in a renal cell cancer phase 2 clinical trial.
- Authors
Jamshidi, Neema; Jonasch, Eric; Zapala, Matthew; Korn, Ronald; Brooks, James; Ljungberg, Borje; Kuo, Michael; Korn, Ronald L; Brooks, James D; Kuo, Michael D
- Abstract
<bold>Objectives: </bold>To characterize a radiogenomic risk score (RRS), a previously defined biomarker, and to evaluate its potential for stratifying radiological progression-free survival (rPFS) in patients with metastatic renal cell carcinoma (mRCC) undergoing pre-surgical treatment with bevacizumab.<bold>Methodology: </bold>In this IRB-approved study, prospective imaging analysis of the RRS was performed on phase II clinical trial data of mRCC patients (n = 41) evaluating whether patient stratification according to the RRS resulted in groups more or less likely to have a rPFS to pre-surgical bevacizumab prior to cytoreductive nephrectomy. Survival times of RRS subgroups were analyzed using Kaplan-Meier survival analysis.<bold>Results: </bold>The RRS is enriched in diverse molecular processes including drug response, stress response, protein kinase regulation, and signal transduction pathways (P < 0.05). The RRS successfully stratified rPFS to bevacizumab based on pre-treatment computed tomography imaging with a median progression-free survival of 6 versus >25 months (P = 0.005) and overall survival of 25 versus >37 months in the high and low RRS groups (P = 0.03), respectively. Conventional prognostic predictors including the Motzer and Heng criteria were not predictive in this cohort (P > 0.05).<bold>Conclusions: </bold>The RRS stratifies rPFS to bevacizumab in patients from a phase II clinical trial with mRCC undergoing cytoreductive nephrectomy and pre-surgical bevacizumab.<bold>Key Points: </bold>• The RRS SOMA stratifies patient outcomes in a phase II clinical trial. • RRS stratifies subjects into prognostic groups in a discrete or continuous fashion. • RRS is biologically enriched in diverse processes including drug response programs.
- Subjects
RENAL cell carcinoma; GENETIC markers; BEVACIZUMAB; COMPUTED tomography; PROGRESSION-free survival; NEPHRECTOMY; PROGNOSIS
- Publication
European Radiology, 2016, Vol 26, Issue 8, p2798
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-015-4082-8