Early assessment with 18F-2-fluoro-2-deoxyglucose positron emission tomography/computed tomography to predict short-term outcome in clear cell renal carcinoma treated with nivolumab
Early assessment with 18F-2-fluoro-2-deoxyglucose positron emission tomography/computed tomography to predict short-term outcome in clear cell renal carcinoma treated with nivolumab
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DOI：
10.1186/s12885-019-5510-y
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发表时间：
2019-04-02
期刊：
影响因子：
3.8
通讯作者：
Yao, Masahiro
中科院分区：
文献类型：
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作者：
Tabei, Tadashi;Nakaigawa, Noboru;Yao, Masahiro
背景我们之前报道了18 F-2-氟-2-脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）在预测分子靶向药物治疗的肾细胞癌（RCC）预后方面的有用性。在此，我们描述了一个初步的研究，9例患者进行FDG-PET/CT之前和之后开始nivolumab.MethodsPatients与转移性RCC谁是治疗nivolumab从2016年10月至2017年3月入组本研究。所有患者均在基线和1个月时接受FDG-PET/CT作为首次缓解评估，并在4个月时接受造影剂增强或非造影剂增强CT扫描作为第二次缓解评估。Logistic回归分析评估潜在的预测因素，包括年龄，性别，基线直径，基线最大标准化摄取值（SUVmax），肺转移与否，第1次评估时SUVmax升高，第1次评估时直径减小与第2次评估时反应（直径减小30%或不减小）的关系。从治疗开始，首次FDG-PET/CT评估和第二次CT扫描评估的平均天数分别为32.36.4、115.514.9。在第二次评估时直径减小30%的病变被定义为有反应，直径未减小30%的病变被定义为无反应。有18个反应病灶，12个无反应病灶。我们分别比较了第一次评估时FDG-PET/CT的直径变化和SUVmax。在首次FDG-PET/CT评估时直径减小和SUVmax升高的所有病变在第二次CT扫描评估时显示出反应，而在首次评估时直径增大和SUVmax降低的大多数病变在第二次评估时显示无反应。多因素Logistic回归分析显示，只有1个月时SUVmax升高是独立预测因素（P=0.025，OR：13.087，95%CI：1.373-124.716）。试验注册在日本大学医院医学信息网注册[UMIN 0000008141]，注册日期：2012年6月11日。
BackgroundWe reported previously the usefulness of 18F-2-fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) to predict prognosis of renal cell carcinoma (RCC) treated with molecular targeted agents. Herein we describe a preliminary research of nine patients who underwent FDG-PET/CT before and after initiation of nivolumab.MethodsPatients with metastatic RCC who were treated by nivolumab from October 2016 to March 2017 were enrolled in this study. All patients underwent FDG-PET/CT at baseline and 1 month as a first response assessment, and contrast-enhanced or non-contrast-enhanced CT scan at 4 month as a second response assessment. Logistic regression analysis was performed to assess the association of potential predictors, including age, gender, baseline diameter, baseline maximum standardized uptake value (SUVmax), lung or not lung metastasis, elevation of SUVmax at 1st assessment, and decrease in diameter at 1st assessment with the response at 2nd assessment (decrease in the diameter30% or not).ResultsThere were 9 patients and 30 lesions. Mean days of first assessment with FDG-PET/CT and second assessment by CT scan from initiation of treatment were 32.36.4, 115.514.9, respectively. Lesions whose diameter decreased 30% at second assessment were defined as responding, and lesions whose diameter did not decrease 30% were defined as non-responding. There were 18 responding lesions, and 12 non-responding lesions. We compared change in diameter and SUVmax at first assessment with FDG-PET/CT, respectively. All lesions with decreased diameter and elevated SUVmax at first assessment with FDG-PET/CT showed responding at second assessment by CT scan, while most lesions with increased diameter and declined SUVmax at first assessment showed non-responding at second assessment. The multivariate logistic regression analyses revealed that only the elevation of SUVmax at 1 month was an independent predictor (P=0.025, OR: 13.087, 95%CI: 1.373-124.716).Conclusion Our findings suggest that the early assessment using FDG-PET/CT can be effective to predict the response of RCC to nivolumab. However, larger prospective studies are needed to confirm these preliminary results.Trial registration Registered in University Hospital Medical Information Network in JAPAN [UMIN0000008141], registration date: 11 Jun 2012.