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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

3360 - Lesion detection by ceCT, 89Zr-girentuximab and FDG PET/CT in newly diagnosed patients (pts) with metastatic clear cell renal cell carcinoma (mccRCC)

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Topics

Staging and Imaging

Tumour Site

Renal Cell Cancer

Presenters

Sarah Verhoeff

Citation

Annals of Oncology (2018) 29 (suppl_8): viii303-viii331. 10.1093/annonc/mdy283

Authors

S.R. Verhoeff1, S. Es2, E. Boon1, E. van Helden3, L. Angus4, S. Elias5, S. Oosting2, E. Aarntzen6, A. Brouwers2, S. Heskamp6, O.S. Hoekstra7, H.M. Verheul3, A.A.M. Van der Veldt4, E.G..E. de Vries2, O. Boerman6, W.T.A. van der Graaf8, W.J.G. Oyen1, C.M.L. van Herpen1

Author affiliations

  • 1 Medical Oncology, Radboud University Medical Centre Nijmegen, 6500 HB - Nijmegen/NL
  • 2 Medical Oncology, University Hospital Groningen (UMCG), 9700 RB - Groningen/NL
  • 3 Medical Oncology, Vrije University Medical Centre (VUMC), 1081 HV - Amsterdam/NL
  • 4 Medical Oncology, Erasmus University Medical Center, 3015 CE - Rotterdam/NL
  • 5 Epidemiolgy, Julius Center of Health Academy, 3584 CG - Utrecht/NL
  • 6 Radiology And Nuclear Medicine, Radboud University Medical Centre Nijmegen, 6500 HB - Nijmegen/NL
  • 7 Radiology & Nuclear Medicine, Vrije University Medical Centre (VUMC), 1081 HV - Amsterdam/NL
  • 8 Division Of Clinical Studies, Royal Marsden Hospital Institute of Cancer Research, SM2 5NG - Sutton/GB

Resources

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Abstract 3360

Background

As slow disease progression is observed in a subset of mccRCC patients, watchful waiting can be considered, thereby postponing toxicity of systemic treatment. To identify those patients, the IMPACT trial evaluated the role of anti-Carbonic Anhydrase IX antibody 89Zr-girentuximab and 18F-fluorodeoxyglucose (FDG) PET/CT (PET). Here, we report preliminary analyses of a secondary endpoint: comparison of baseline contrast-enhanced(ce)CT, 89Zr-girentuximab and FDG PET to detect metastases.

Methods

mccRCC pts with good or intermediate prognosis (according to IMDC) and eligible for watchful waiting were included. Patients underwent 3 scans, i.e. ceCT, 89Zr-girentuximab and 18F-FDG PET. So far, baseline scans of 29 of the 40 pts to be accrued were independently reviewed by 3 experienced readers. Lesions by ceCT were defined positive according to RECIST1.1. For lesions with prominent uptake of 89Zr-girentuximab or 18F-FDG, maximum Standardized Uptake Values (SUVmax) were calculated. Analyses were performed on a lesion level, taking clustering of data within patients and lesions into account.

Results

In total 325 lesions were detected by at least one modality (mean 11(2-33) per pt); ceCT detected 52% (95%CI:45;58), 18F-FDG PET 61% (95%CI:55;67) and 89Zr-girentuximab PET 69% (95%CI:63;74). Differences in lesion detection varied across organ sites(p < 0.001). Lesions were visualized by ceCT and 18F-FDG PET in all pts,whereas 89Zr-girentuximab PET detected lesions in 27 of 29 pts. Compared to ceCT, 89Zr-girentuximab PET visualized additional lesions in all organ sites. Location was strongly related with 89Zr-girentuximab uptake; highest uptake in kidney and adrenal gland tumor (mean SUVmax 63.2 and 70.3, resp) and lowest uptake in lung and lymph nodes (mean SUVmax 10.9 and 15.0, resp). After correction for location, no relation was observed between 89Zr-girentuximab SUVmax and tumor size, as measured by ceCT, and 18F-FDG SUVmax.

Conclusions

89Zr-girentuximab and 18F-FDG PET visualize additional lesions compared to ceCT, however correlation was poor. The addition of 89Zr-girentuximab or 18F-FDG PET might aid in deciding to either delay or start systemic treatment.

Clinical trial identification

NCT02228954.

Legal entity responsible for the study

Radboud University Medical Center (Radboudumc).

Funding

Supported by the Dutch Cancer Society.

Editorial Acknowledgement

Supported by the Dutch Cancer Society

Disclosure

All authors have declared no conflicts of interest.

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