1. Assessment of response to anti-angiogenic targeted therapy in pulmonary metastatic renal cell carcinoma: R2* value as a predictive biomarker.
- Author
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Wu, Guangyu, Liu, Guiqin, Kong, Wen, Qu, Jianxun, Suo, Shiteng, Liu, Xiaosheng, Xu, Jianrong, and Zhang, Jin
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RENAL cell carcinoma , *TUMOR markers , *VASCULAR endothelial growth factors , *KAPLAN-Meier estimator , *TREATMENT effectiveness , *THERAPEUTICS , *ANTINEOPLASTIC agents , *NEOVASCULARIZATION inhibitors , *HETEROCYCLIC compounds , *INDOLE compounds , *UREA , *COMPARATIVE studies , *COMPUTED tomography , *KIDNEY tumors , *LUNG tumors , *MAGNETIC resonance imaging , *RESEARCH methodology , *MEDICAL cooperation , *RESEARCH , *VITAMIN B complex , *EVALUATION research , *RESEARCH bias , *RETROSPECTIVE studies , *RECEIVER operating characteristic curves , *VITAMIN therapy ,RESEARCH evaluation - Abstract
Purpose: To evaluate the utility of MR R2*-mapping and the optimal time-point for assessing the response of pulmonary metastatic renal cell carcinoma (mRCC) to anti-angiogenic targeted therapy (aATT).Materials and Methods: The exploration-sample group and the validation-sample group consisted of 22 and 16 patients. The parameters of MR R2*-mapping, including the R2* value at each time-point (R2*base, R2*1cyc and R2*2cyc) and change between different time-points (R2*(1cyc-base)/base, R2*(2cyc-base)/base and R2*(2cyc-1cyc)/1cyc), were evaluated with a receiver-operating-characteristic analysis, and a cut-off value derived from the clinical outcome was applied to the Kaplan-Meier method to assess the value of R2* mapping and Response-Evaluation-Criteria in Solid Tumours (RECIST) during treatment evaluation.Results: The inter-, intra-observer agreements and inter-scan consistency were excellent (p > 0.80). For the exploration-sample group, the areas under the curve for the parameters of MR R2* mapping were 0.55, 0.60, 0.83, 0.64, 0.88 and 0.83 for R2*base, R2*1cyc, R2*2cyc, R2*(1cyc-base)/base, R2*(2cyc-base)/base and R2*(2cyc-1cyc)/1cyc. For the validation-sample, R2*(2cyc-base)/base better predicted progression-free survival (p = 0.03) than RECIST and other R2* mapping parameters with a lower p value.Conclusion: Assessing aATT outcome based on changes in the R2* value between baseline and second treatment is more accurate than assessment at other time-points and assessment based on the RECIST.Key Points: • The inter-scan consistency of R2*-mapping in pulmonary mRCC are excellent. • The intra-/inter-observer agreement of R2* mapping in pulmonary mRCC are excellent. • Using changes in R2* value between baseline/after second-treatment is better than RECIST. • The choice of baseline/after second treatment is better than other time-points. [ABSTRACT FROM AUTHOR]- Published
- 2017
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