Contrast media enhancement reduction predicts tumor response to presurgical molecular-targeting therapy in patients with advanced renal cell carcinoma.
Contrast media enhancement reduction predicts tumor response to presurgical molecular-targeting therapy in patients with advanced renal cell carcinoma.
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对比培养基增强可预测晚期肾细胞癌患者的肿瘤对术中分子靶向治疗的反应。
DOI：
10.18632/oncotarget.17930
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发表时间：
2017-07-25
期刊：
影响因子：
--
通讯作者：
Ohyama C
中科院分区：
文献类型：
--
作者：
Hosogoe S;Hatakeyama S;Kusaka A;Hamano I;Tanaka Y;Hagiwara K;Hirai H;Morohashi S;Kijima H;Yamamoto H;Tobisawa Y;Yoneyama T;Yoneyama T;Hashimoto Y;Koie T;Ohyama C
分子靶向药物治疗晚期肾细胞癌（RCC）的肿瘤反应定量评价仍存在争议。我们的目的是评估接受术前治疗的晚期肾癌患者的放射学肿瘤反应和病理学反应之间的关系。34例患者中，31例行根治性肾切除术。术前治疗药物包括阿西替尼（n = 26）、依维莫司（n = 3）、舒尼替尼（n = 1）和阿西替尼，随后是替西罗莫司（n = 1）。主要的术前治疗相关不良事件为2级或3级高血压（44%）。根据RECIST、Choi和CMER评估的中位放射学肿瘤缓解率分别为− 19%、− 24%和− 49%。在放射学肿瘤反应试验中，CMER与手术标本中肿瘤坏死的相关性高于其他试验。Ki 67/MIB 1状态在手术标本中比在活检标本中显著降低。CMER中与肿瘤坏死百分比相关的回归线斜率的大小大于Choi和RECIST。在2012年3月至2016年12月期间，我们前瞻性招募了34例局部晚期和/或转移性RCC患者，他们接受了术前分子靶向治疗，随后进行了根治性肾切除术。主要终点是比较实体瘤疗效评价标准（RECIST）、Choi和造影剂增强降低（CMER）之间的放射学肿瘤缓解。次要终点包括病理学降级、治疗相关不良事件、术后并发症、Ki 67/MIB 1状态和肿瘤坏死。CMER可预测术前分子靶向治疗后的肿瘤反应。需要进行更大规模的前瞻性研究来评估分子靶向治疗的最佳肿瘤反应。
A quantitative tumor response evaluation to molecular-targeting agents in advanced renal cell carcinoma (RCC) is debatable. We aimed to evaluate the relationship between radiologic tumor response and pathological response in patients with advanced RCC who underwent presurgical therapy. Of 34 patients, 31 underwent scheduled radical nephrectomy. Presurgical therapy agents included axitinib (n = 26), everolimus (n = 3), sunitinib (n = 1), and axitinib followed by temsirolimus (n = 1). The major presurgical treatment-related adverse event was grade 2 or 3 hypertension (44%). The median radiologic tumor response by RECIST, Choi, and CMER were −19%, −24%, and −49%, respectively. Among the radiologic tumor response tests, CMER showed a higher association with tumor necrosis in surgical specimens than others. Ki67/MIB1 status was significantly decreased in surgical specimens than in biopsy specimens. The magnitude of the slope of the regression line associated with the tumor necrosis percentage was greater in CMER than in Choi and RECIST. Between March 2012 and December 2016, we prospectively enrolled 34 locally advanced and/or metastatic RCC who underwent presurgical molecular-targeting therapy followed by radical nephrectomy. Primary endpoint was comparison of radiologic tumor response among Response Evaluation Criteria in Solid Tumors (RECIST), Choi, and contrast media enhancement reduction (CMER). Secondary endpoint included pathological downstaging, treatment related adverse events, postoperative complications, Ki67/MIB1 status, and tumor necrosis. CMER may predict tumor response after presurgical molecular-targeting therapy. Larger prospective studies are needed to develop an optimal tumor response evaluation for molecular-targeting therapy.
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影响因子：
1.8
作者：
Koie T;Ohyama C;Okamoto A;Yamamoto H;Imai A;Hatakeyama S;Yoneyama T;Hashimoto Y
通讯作者：
Hashimoto Y
影响因子：
45.3
作者：
Cowey, C. Lance;Amin, Chirag;Rathmell, W. Kimryn
通讯作者：
Rathmell, W. Kimryn
影响因子：
45.3
作者：
Choi, Haesun;Charnsangavej, Chuslip;Benjamin, Robert S.
通讯作者：
Benjamin, Robert S.
影响因子：
19.7
作者：
Smith, Andrew D.;Zhang, Xu;Griswold, Michael
通讯作者：
Griswold, Michael
影响因子：
6.6
作者：
Thomas, Anil A.;Rini, Brian I.;Campbell, Steven C.
通讯作者：
Campbell, Steven C.