Early response assessment to targeted therapy in metastatic clear cell renal cancer using 68Ga-PSMA-11 PET/CT and comparison with CECT: a feasibility study

IF 2.3 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical and Translational Imaging Pub Date : 2024-04-09 DOI:10.1007/s40336-024-00627-2

Piyush Aggarwal, Harmandeep Singh, Chandan K. Das, Ravimohan S. Mavuduru, Anupam Lal, Nandita Kakkar, Rajender Kumar, Ujjwal Gorsi, Pratibha Prashar, Bhagwant R. Mittal

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引用次数: 0

Abstract

Purpose

Contrast-enhanced computed tomography (CECT) underestimates the response to targeted therapy in metastatic renal cell cancer (mRCC) using Response Assessment Criteria In Solid Tumors (RECIST) v1.1, creating an unmet need for better imaging biomarkers for early response assessment. This study explores the feasibility of early response assessment to targeted therapy in metastatic clear cell RCC (ccRCC) using ⁶⁸Ga-PSMA-11 PET/CT.

Methods

After informed consent, adult patients with biopsy-proven metastatic ccRCC planned for targeted therapy were recruited in this prospective observational pilot study from May 2021 to December 2022. ⁶⁸Ga-PSMA-11 PET/CT was conducted at baseline and one and three months post-treatment. The concordance between PET and CT responses at one and three months was analysed. Follow-up and comparison of progression-free survival (PFS) between responders and non-responders on PET and CT was done.

Results

Twenty-one metastatic ccRCC patients were included in the final analysis. The response assessment on PET and CT was discordant in 15 out of 21 patients (~ 71%) at one month and in nine out of 21 patients (~ 43%) at three months. There was no significant difference between the median PFS of responders vs non-responders on CT at one (14 m vs. 12 m, p = 0.9) and three months (14 m vs. 12 m, p = 0.6). However, a higher difference in median PFS was observed between responders and non-responders on PET at one (PFS 14 m vs. 1 m, p < 0.001) and three months (PFS 14 m vs. 3 m, p = 0.28), respectively.

Conclusion

Early response assessment with ⁶⁸Ga-PSMA-11 PET/CT is feasible and provides more accurate prognostic information than CECT in metastatic clear cell RCC patients undergoing targeted therapy.

Trial registration number

CTRI/2021/05/033805 (date of registration: 25/05/21)

Abstract Image

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使用 68Ga-PSMA-11 PET/CT 对转移性透明细胞肾癌靶向治疗的早期反应进行评估并与 CECT 进行比较：一项可行性研究

目的根据实体瘤反应评估标准（RECIST）v1.1版，对比增强计算机断层扫描（CECT）低估了转移性肾细胞癌（mRCC）对靶向治疗的反应，因此需要更好的成像生物标志物来进行早期反应评估。本研究探讨了使用68Ga-PSMA-11 PET/CT评估转移性透明细胞RCC（ccRCC）靶向治疗早期反应的可行性。方法2021年5月至2022年12月期间，本前瞻性观察试验研究招募了经活检证实计划接受靶向治疗的转移性ccRCC成人患者。68Ga-PSMA-11 PET/CT 在基线和治疗后的 1 个月和 3 个月进行。分析了 PET 和 CT 在 1 个月和 3 个月时反应的一致性。结果21例转移性ccRCC患者被纳入最终分析。21 例患者中有 15 例（约 71%）在一个月时 PET 和 CT 的反应评估不一致，21 例患者中有 9 例（约 43%）在三个月时 PET 和 CT 的反应评估不一致。在一个月（14 米对 12 米，P = 0.9）和三个月（14 米对 12 米，P = 0.6）时，CT 有反应与无反应患者的中位生存期无明显差异。然而，在 PET 上观察到的有反应者和无反应者的中位生存期差异较高，分别为 1 个月（生存期为 14 米对 1 米，p = 0.001）和 3 个月（生存期为 14 米对 3 米，p = 0.28）。结论在接受靶向治疗的转移性透明细胞 RCC 患者中，使用 68Ga-PSMA-11 PET/CT 进行早期反应评估是可行的，而且能提供比 CECT 更准确的预后信息。试验注册号：CTRI/2021/05/033805（注册日期：25/05/21）

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来源期刊

Clinical and Translational Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

3.60

自引率

4.80%

发文量

期刊介绍： Clinical and Translational Imaging is an international journal that publishes timely, up-to-date summaries on clinical practice and translational research and clinical applications of approved and experimental radiopharmaceuticals for diagnostic and therapeutic purposes. Coverage includes such topics as advanced preclinical evidence in the fields of physics, dosimetry, radiation biology and radiopharmacy with relevance to applications in human subjects. The journal benefits a readership of nuclear medicine practitioners and allied professionals involved in molecular imaging and therapy.