One-month assessment of renal cell carcinoma treated by everolimus using FDG PET/CT predicts progression-free and overall survival

We evaluated (18)F-2-fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG PET/CT) results as outcome predictors for patients with metastatic renal cell carcinoma (RCC) treated by everolimus (EVL), an inhibitor of mammalian target of rapamycin.

We retrospectively reviewed 30 patients who were treated with EVL for metastatic RCC between May 2010 and March 2015, by evaluating their FDG PET/CT result before and 1 month after starting EVL treatment. We examined the relationships between each patient's maximum standardized uptake value (max SUVmax) assessed by FDG PET/CT on progression-free survival (PFS) and overall survival (OS).

Median PFS for all 30 patients was 3.77 months (range 0.72-24.56 months) and median OS after EVL treatment of all 30 patients was 11.67 months (range 1.0-62.98 months). Enrolled patients were divided into two groups by max SUVmax prior to EVL (median = 7.6) and at 1 month after EVL treatment (median = 5.7). PFS were significantly shorter in higher max SUVmax prior to EVL (<7.6, PFS 7.8 vs 3.5 months, log-rank P = 0.017) and at 1 month after EVL (<5.7, PFS 10.6 vs 2.7 months, log-rank P = 0.002) than lower max SUVmax. OS were also significantly shorter in higher max SUVmax prior to EVL (<7.6, OS 18.1 vs 7.5 months, log-rank P = 0.010) and at 1 month after EVL (<5.7, OS 17.2 vs 7.5 months, log-rank P = 0.009) than lower max SUVmax. Multivariate Cox hazard regression analysis indicated that max SUVmax at 1 month after EVL is an independent predictor of both PFS and OS in patients treated with EVL although univariate regression analysis showed max SUVmax before EVL is a possible predictor.

Max SUVmax assessed by FDG PET/CT prior to EVL and at 1 month after EVL treatment can accurately predict PFS and can guide decisions on whether to continue or change treatments for patients with EVL-treated RCC who suffer from adverse events.

Cancer chemotherapy and pharmacology. 2017 Mar 22 [Epub ahead of print]

Hiroki Ito, Keiichi Kondo, Takashi Kawahara, Tomohiro Kaneta, Ukihide Tateishi, Daiki Ueno, Kazuhiro Namura, Kazuki Kobayashi, Yasuhide Miyoshi, Yasushi Yumura, Kazuhide Makiyama, Narihiko Hayashi, Hisashi Hasumi, Kimito Osaka, Yumiko Yokomizo, Jun-Ichi Teranishi, Yusuke Hattori, Tomio Inoue, Hiroji Uemura, Masahiro Yao, Noboru Nakaigawa

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan., Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan., Department of Urology, Yokosuka Kyosai Hospital, Yokosuka, Japan., Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan. .

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