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

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Abstract

Purpose

We evaluated 18F-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.

Methods

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).

Results

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.

Conclusions

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.

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Acknowledgements

This work was supported in part by Grants-in-Aid for Scientific Research (No. 25462494 and 16K11021) from the Ministry of Education, Science, Sports and Culture of Japan.

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Authors and Affiliations

  1. Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Hiroki Ito, Keiichi Kondo, Takashi Kawahara, Daiki Ueno, Kazuhiro Namura, Yasuhide Miyoshi, Yasushi Yumura, Kazuhide Makiyama, Narihiko Hayashi, Hisashi Hasumi, Kimito Osaka, Yumiko Yokomizo, Jun-ichi Teranishi, Yusuke Hattori, Hiroji Uemura, Masahiro Yao & Noboru Nakaigawa

  2. Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Tomohiro Kaneta, Ukihide Tateishi & Tomio Inoue

  3. Department of Urology, Yokosuka Kyosai Hospital, Yokosuka, Japan

    Kazuki Kobayashi

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  1. Hiroki Ito
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  2. Keiichi Kondo
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  3. Takashi Kawahara
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  11. Kazuhide Makiyama
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  19. Hiroji Uemura
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  21. Noboru Nakaigawa
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Corresponding author

Correspondence to Noboru Nakaigawa.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study protocol was approved by the Yokohama City University Institutional Review Board. Written informed consent was obtained from all patients.

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Ito, H., Kondo, K., Kawahara, T. et al. One-month assessment of renal cell carcinoma treated by everolimus using FDG PET/CT predicts progression-free and overall survival. Cancer Chemother Pharmacol 79, 855–861 (2017). https://doi.org/10.1007/s00280-017-3275-z

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  • DOI: https://doi.org/10.1007/s00280-017-3275-z

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