Pilot study of DCE-MRI to predict progression-free survival with sorafenib therapy in renal cell carcinoma

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作者：

KT Flaherty，MA Rosen，DF Heitjan，ML Gallagher，PJ O'Dwyer

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摘要：

Background: The investigation of angiogenesis inhibitors is of particular interest in renal cell carcinoma (RCC), in which dysregulated blood vessel formation has been correlated with shortened survival. Sorafenib is a novel RAF and VEGF receptor tyrosine kinase inhibitor. We conducted this study to (a) determine if sorafenib is anti-angiogenic, and (b) to relate anti-angiogenic effect to outcome. Patients and Methods: Seventeen patients with metastatic RCC underwent dynamic- contrast enhanced magnetic resonance imaging (DCE-MRI). DCE-MRI was used to calculate the gadolinium exchange constant between blood and tumor interstitial tissue, Ktrans. Results: Four patients achieved partial response by WHO criteria (ORR 24%). Median time to progression (TTP) was 12.9 months. Ktrans decreased significantly during treatment with sorafenib (60.3% decline, 95% CI 46.1-74.6%). The percent decline in Ktrans and change in tumor size by CT scan were significantly associated with progression-free survival (p=0.01and 0.05, respectively). In addition, Ktrans at baseline was also significantly associated with progress-free survival (p = 0.02). Conclusions: In patients with RCC, inhibition of tumor vascular permeability by sorafenib was associated with improved outcome. Moreover, baseline tumor vascular permeability, expected to be a poor prognosis factor, was a predictive marker of favorable response to therapy.

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关键词：

Carcinoma, Renal Cell survival aspects Magnetic Resonance Imaging Progression 癌, 肾细胞磁共振成像

DOI：

10.4161/cbt.7.4.5624

被引量：

397

年份：

2008