FDG PET/CT after first molecular targeted therapy predicts survival of patients with renal cell carcinoma

We investigated prospectively whether18F-2-fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG PET/CT) can predict the overall survival (OS) of patients with advanced renal cell carcinoma (RCC) previously treated by molecular targeted therapies.

Between 2009 and 2016, 81 patients who had received single molecular targeted therapies (43 sorafenib, 27 sunitinib, 8 temsirolimus and others) and were scheduled for second line molecular targeted therapies for advanced RCC were enrolled in this prospective study. FDG PET/CT was performed after first line molecular targeted therapies, the max SUVmax (highest standardized uptake value for each patient) recorded, and its association with OS compared with those of known risk factors. The median follow-up was 15.4 months (range 0.9-97.4 months).

The max SUVmax of the 81 subjects ranged from undetectable to 23.0 (median 7.1). Patients with high max SUVmax had a poor prognosis and multivariate analysis with established risk factors showed that it was an independent predictor of survival (p < 0.001; hazard ratio 1.156; 95% confidence interval 1.080-1.239). Subclassification of patients by max SUVmax showed that the median OS of patients with max SUVmax < 7.0 (39), 7.0-12.0 (30), and ≥ 12.0 (12) were 32.8, 15.2, and 6.0 months, respectively. These differences are statistically significant (< 7.0 versus 7.0-12.0: p = 0.0333, 7.0-12.0 versus ≥ 12.0: p = 0.0235).

The max SUVmax by FDG PET/CT of patients with RCC evaluated after their first molecular targeted therapy predicts OS. FDG PET/CT is a useful "imaging biomarker" for patients with advanced RCC planning sequential molecular targeted therapies.

Cancer chemotherapy and pharmacology. 2018 Feb 20 [Epub ahead of print]

Noboru Nakaigawa, Keiichi Kondo, Tomohiro Kaneta, Ukihide Tateishi, Ryogo Minamimoto, Kazuhiro Namura, Daiki Ueno, Kazuki Kobayashi, Takeshi Kishida, Ichiro Ikeda, Hisashi Hasumi, Kazuhide Makiyama, Narihiko Hayashi, Kimito Osaka, Kentaro Muraoka, Koji Izumi, Takashi Kawahara, Jun-Ichi Teranishi, Yasuhide Miyoshi, Yasushi Yumura, Hiroji Uemura, Tomio Inoue, Masahiro Yao

Department of Urology, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 236-0004, Japan. ., Department of Urology, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 236-0004, Japan., Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan., Department of Urology, Yokosuka Kyosai Hospital, Yokosuka, Japan., Department of Urology, Kanagawa Cancer Center, Yokohama, Japan., Department of Urology, Yokohama Minami Kyosai Hospital, Yokohama, Japan.

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