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- Title
Assessment of response to anti-angiogenic targeted therapy in pulmonary metastatic renal cell carcinoma: R2* value as a predictive biomarker.
- Authors
Wu, Guangyu; Liu, Guiqin; Kong, Wen; Qu, Jianxun; Suo, Shiteng; Liu, Xiaosheng; Xu, Jianrong; Zhang, Jin
- Abstract
<bold>Purpose: </bold>To evaluate the utility of MR R2*-mapping and the optimal time-point for assessing the response of pulmonary metastatic renal cell carcinoma (mRCC) to anti-angiogenic targeted therapy (aATT).<bold>Materials and Methods: </bold>The exploration-sample group and the validation-sample group consisted of 22 and 16 patients. The parameters of MR R2*-mapping, including the R2* value at each time-point (R2*base, R2*1cyc and R2*2cyc) and change between different time-points (R2*(1cyc-base)/base, R2*(2cyc-base)/base and R2*(2cyc-1cyc)/1cyc), were evaluated with a receiver-operating-characteristic analysis, and a cut-off value derived from the clinical outcome was applied to the Kaplan-Meier method to assess the value of R2* mapping and Response-Evaluation-Criteria in Solid Tumours (RECIST) during treatment evaluation.<bold>Results: </bold>The inter-, intra-observer agreements and inter-scan consistency were excellent (p > 0.80). For the exploration-sample group, the areas under the curve for the parameters of MR R2* mapping were 0.55, 0.60, 0.83, 0.64, 0.88 and 0.83 for R2*base, R2*1cyc, R2*2cyc, R2*(1cyc-base)/base, R2*(2cyc-base)/base and R2*(2cyc-1cyc)/1cyc. For the validation-sample, R2*(2cyc-base)/base better predicted progression-free survival (p = 0.03) than RECIST and other R2* mapping parameters with a lower p value.<bold>Conclusion: </bold>Assessing aATT outcome based on changes in the R2* value between baseline and second treatment is more accurate than assessment at other time-points and assessment based on the RECIST.<bold>Key Points: </bold>• The inter-scan consistency of R2*-mapping in pulmonary mRCC are excellent. • The intra-/inter-observer agreement of R2* mapping in pulmonary mRCC are excellent. • Using changes in R2* value between baseline/after second-treatment is better than RECIST. • The choice of baseline/after second treatment is better than other time-points.
- Subjects
RENAL cell carcinoma; TUMOR markers; VASCULAR endothelial growth factors; KAPLAN-Meier estimator; TREATMENT effectiveness; THERAPEUTICS; ANTINEOPLASTIC agents; NEOVASCULARIZATION inhibitors; HETEROCYCLIC compounds; INDOLE compounds; UREA; COMPARATIVE studies; COMPUTED tomography; KIDNEY tumors; LUNG tumors; MAGNETIC resonance imaging; RESEARCH methodology; MEDICAL cooperation; RESEARCH; RESEARCH evaluation; VITAMIN B complex; EVALUATION research; RESEARCH bias; RETROSPECTIVE studies; RECEIVER operating characteristic curves; VITAMIN therapy
- Publication
European Radiology, 2017, Vol 27, Issue 9, p3574
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-016-4700-0