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Tumor response criteria for assessing pazopanib first-line therapy in patients with metastatic renal cell carcinoma (mRCC)

  • Kidneys, Ureters, Bladder, Retroperitoneum
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To identify the optimum response criteria for first-line targeted pazopanib therapy in patients with mRCC using solid tumor response criteria and clinical risk factors.

Methods

Pre- and post-treatment CTs of patients (n = 43) with mRCC treated with first-line pazopanib therapy were analyzed retrospectively. Treatment response was evaluated with Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, Choi, modified Choi (mChoi), revised Choi (rChoi), MASS (Morphology, Attenuation, Size, and Structure), 10% threshold criteria, and subjective assessment. Memorial Sloan-Kettering Cancer Center and International Metastatic Renal Cell Carcinoma Database Consortium clinical risk factors were also used to define response groups. Response evaluations were correlated with overall survival (OS) and progression-free survival (PFS) using log-rank test.

Results

Patients with partial response (PR) by mChoi and rChoi had longer OS than those with stable disease (SD) (P < 0.001). Responders by 10% threshold criteria also had better OS, without or combined with clinical criteria. Patients with PR by rChoi, mChoi, RECIST v1.1, MASS criteria, and by subjective assessment had longer PFS than those with SD. rChoi and mChoi criteria best delineated the difference in PFS for patients with PR versus SD, without or combined with clinical criteria.

Conclusion

For mRCC patients treated with pazopanib, OS and PFS for PR and SD groups were best predicted by rChoi and mChoi criteria, without or combined with clinical risk factors. 10% threshold criteria also predicted OS and PFS, whereas RECIST did so only in a limited number of patients.

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References

  1. Eisenhauer EA, Therasse P, Bogaerts J et al (2009) New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). European journal of cancer (Oxford, England: 1990) 45:228-247

  2. Kang HC, Gupta S, Wei W, Lu L, Matrana MR, Tannir NM, Choi H (2017) Alternative response criteria and clinical risk factors for assessing tumor response in patients with metastatic renal cell carcinoma who are receiving salvage therapy. AJR Am J Roentgenol 209: 1278-1284

    Article  Google Scholar 

  3. Hutson TE, Davis ID, Machiels JP et al (2010) Efficacy and safety of pazopanib in patients with metastatic renal cell carcinoma. J Clin Oncol 28:475-480

    Article  CAS  Google Scholar 

  4. Ratain MJ, Eisen T, Stadler WM, et al (2006) Phase II placebo-controlled randomized discontinuation trial of sorafenib in patients with metastatic renal cell carcinoma. J Clin Oncol 24:2505-2512

    Article  CAS  Google Scholar 

  5. Choi H, Charnsangavej C, Faria SC et al (2007) Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: proposal of new computed tomography response criteria. J Clin Oncol 25:1753-1759.

    Article  Google Scholar 

  6. Nathan PD, Vinayan A, Stott D, Juttla J, Goh V (2010) CT response assessment combining reduction in both size and arterial phase density correlates with time to progression in metastatic renal cancer patients treated with targeted therapies. Cancer Biol Ther 9:15-19

    Article  Google Scholar 

  7. Smith AD, Shah SN, Rini BI, Lieber ML, Remer EM (2010) Morphology, Attenuation, Size, and Structure (MASS) criteria: assessing response and predicting clinical outcome in metastatic renal cell carcinoma on antiangiogenic targeted therapy. AJR Am J Roentgenol 194:1470-1478

    Article  Google Scholar 

  8. Thiam R, Fournier LS, Trinquart L et al (2010) Optimizing the size variation threshold for the CT evaluation of response in metastatic renal cell carcinoma treated with sunitinib. Ann Oncol 21:936-941

    Article  CAS  Google Scholar 

  9. Krajewski KM, Guo M, Van den Abbeele AD et al (2011) Comparison of four early posttherapy imaging changes (EPTIC; RECIST 1.0, tumor shrinkage, computed tomography tumor density, Choi criteria) in assessing outcome to vascular endothelial growth factor-targeted therapy in patients with advanced renal cell carcinoma. Eur Urol 59:856-862

    Article  Google Scholar 

  10. Motzer RJ, Mazumdar M, Bacik J, Berg W, Amsterdam A, Ferrara J (1999) Survival and prognostic stratification of 670 patients with advanced renal cell carcinoma. J Clin Oncol 17:2530-2540

    Article  CAS  Google Scholar 

  11. Motzer RJ, Bacik J, Schwartz LH, Reuter V, Russo P, Marion S, Mazumdar M (2004) Prognostic factors for survival in previously treated patients with metastatic renal cell carcinoma. J Clin Oncol 22:454-463.

    Article  Google Scholar 

  12. Ko JJ, Xie W, Kroeger N, et al (2015) The international metastatic renal cell carcinoma database consortium model as a prognostic tool in patients with metastatic renal cell carcinoma previously treated with first-line targeted therapy: a popluation-based study. The Lancet Oncology 16:293-300

    Article  Google Scholar 

  13. Goh V, Ganeshan B, Nathan P, Juttla JK, Vinayan A, Miles KA (2011) Assessment of response to tyrosine kinase inhibitors in metastatic renal cell cancer: CT texture as a predictive biomarker. Radiology 261:165-171

    Article  Google Scholar 

  14. Fournier L, Bellucci A, Vano Y, et al (2017) Imaging response of antiangiogenic and immune-oncology drugs in metastatic renal cell carcinoma (mRCC): current status and future challenges. Kidney Cancer 1:107-114

    Article  Google Scholar 

Download references

Funding

Supported by the NIH/NCI under Award Number P30CA016672 and used the CCSG Biostatistics Resource Group.

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Authors and Affiliations

  1. Department of Abdominal Imaging, Unit 1473, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Shiva Gupta, Hyunseon C. Kang & Haesun Choi

  2. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Jia Sun

  3. Department of Hematology and Oncology, Ochsner Cancer Institute, New Orleans, LA, 70121, USA

    Marc R. Matrana

  4. Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Nizar M. Tannir

Authors
  1. Shiva Gupta
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  2. Hyunseon C. Kang
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  3. Jia Sun
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  4. Marc R. Matrana
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  5. Nizar M. Tannir
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  6. Haesun Choi
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Corresponding author

Correspondence to Shiva Gupta.

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Conflict of interest

Shiva Gupta, MD; Hyunseon Christine Kang, MD PhD; Jia Sun, PhD; and Haesun Choi, MD have no disclosures. Marc R. Matrana, MD—Speaker’s Bureau: BMS, AstraZeneca, Janssen, Genentech, Eisai, Merck; Consultant: Strata Oncology, AstraZeneca. No funding was received for this study. Nizar M. Tannir, MD—Honoraria: Pfizer, Novartis, Bristol-Myers Squibb, Exelixis, Nektar; Calithera Biosciences, Eisai Medical Research, Ono Pharmaceutical; Consultant: Novartis; Exelixis, BMS, Nektar, Pfizer, Eisai, Calithera Biosciences Inc., Ono Pharmaceutical, Oncorena. Research Funding: BMS, Novartis, Exelixis, Epizyme, Mirati Therapeutics. No funding was received for this study.

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Gupta, S., Kang, H.C., Sun, J. et al. Tumor response criteria for assessing pazopanib first-line therapy in patients with metastatic renal cell carcinoma (mRCC). Abdom Radiol 45, 1872–1882 (2020). https://doi.org/10.1007/s00261-019-02354-z

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  • DOI: https://doi.org/10.1007/s00261-019-02354-z

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