852P - Can radiological parameters predict the outcome in metastatic renal cell carcinoma (mRCC) patients treated with sunitinib? Usefulness of normalized...

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Cytotoxic agents
Renal Cell Cancer
Staging procedures (clinical staging)
Basic Principles in the Management and Treatment (of cancer)
Imaging
Therapy
Biological therapy
Presenter Oscar Reig
Citation Annals of Oncology (2014) 25 (suppl_4): iv280-iv304. 10.1093/annonc/mdu337
Authors O. Reig1, I. Victoria Ruiz2, B. Paño3, M. Campayo4, C. Nicolau3, B. Mellado5, M.C. Sebastia3
  • 1Medical Oncology, Hospital Clinic y Provincial de Barcelona, 08036 - Barcelona/ES
  • 2Medical Oncology, Hospital Clinic de Barcelona, 08036 - Barcelona/ES
  • 3Radiology, Hospital Clínic de Barcelona, Barcelona/ES
  • 4Oncologia Medica, Hospital Clinic y Provincial de Barcelona, 08036 - Barcelona/ES
  • 5Oncology Department, Hospital Clínic de Barcelona, Barcelona/ES

Abstract

Aim

Despite of the efforts, clinically useful biomarkers in mRCC remain unknown. The aim is to determine if radiological parameters can be useful to predict mRCC outcome to sunitinib.

Methods

Twenty-six mRCC patients treated with first-line sunitinib were enrolled in this study. A volumetric study (21 cm) with perfusion-CT (Flash Definition, Siemens, Erlangen, Germany) was done in these patients before starting the treatment, 1 and 4 months after treatment initiation. Baseline size, normalized arterial (NAD) and venous density, and perfusion parameters (blood flow (BF), blood volume (BV) and permeability) and changes on these parameters were analysed.

Results

80.8% of the patients were men with a median age of 59.8 years (35.8 – 75.4). Clear cell carcinoma was the most frequent histology (73%) and 58% of the patient had a good prognosis according to MSKCC classification. According to RECIST criteria, 8 patients achieve a partial response (30.7%), 1 a complete response (3.8%), 6 stable disease (23.1%), 6 progressive disease (23.1) and 5 were not evaluable (19.2%). Patients that develop progressive disease had lower NAD (p = 0.0328) and BF (p = 0.0487) on pre-treatment CT. Higher basal NAD (median PFS in months: NA vs 6.8), p = 0.0154) and BF (17.23 vs 6.43, p = 0.0154) correlated with a longer progression-free survival (PFS). Baseline size did not present correlation with PFS. A high correlation between basal NAD and BF were found (R = 0.737, p < 0.05). Regarding changes between baseline CT and first month one, the patients with progressive disease had lower reduction in NAD and BF but only changes in NAD had correlation with PFS (6.97 vs 17.23, p = 0.0119). First month CT showed changes in NAD, BF or BV but changes in size were observed on 4 month's CT.

Conclusions

Normalized arterial density and blood flow are potential biomarkers of response to sunitinib in mRCC patients.

Disclosure

All authors have declared no conflicts of interest.