TY - JOUR
T1 - [89Zr]Zr-DFO-girentuximab and [18F]FDG PET/CT to predict watchful waiting duration in patients with metastatic clear cell renal cell carcinoma
AU - Verhoeff, Sarah R
AU - Oosting, Sjoukje F
AU - Elias, Sjoerd G
AU - van Es, Suzanne C
AU - Gerritse, Sophie L
AU - Angus, Lindsay
AU - Heskamp, Sandra
AU - Desar, Ingrid M E
AU - Menke-van der Houven van Oordt, C Willemien
AU - van der Veldt, Astrid A M
AU - Arens, Anne I J
AU - Brouwers, Adrienne H
AU - Eisses, Bertha
AU - Mulders, Peter F A
AU - Hoekstra, Otto S
AU - Zwezerijnen, Gerben J C
AU - van der Graaf, Winette T A
AU - Aarntzen, Erik H J G
AU - Oyen, Wim J G
AU - van Herpen, Carla M L
PY - 2023/2/1
Y1 - 2023/2/1
N2 - PURPOSE: Watchful waiting (WW) can be considered for patients with metastatic clear cell renal cell carcinoma (mccRCC) with good or intermediate prognosis, especially those with <2 International Metastatic RCC Database Consortium criteria and ≤2 metastatic sites (referred to as watch and wait ("W&W")-criteria). The IMPACT-RCC study objective was to assess the predictive value of [18F]FDG- and [89Zr]Zr-DFO-girentuximab-PET/CT for WW-duration in patients with mccRCC.PATIENTS AND METHODS: Between February 2015 and March 2018, 48 patients were enrolled, including 40 evaluable patients with good (n=14) and intermediate (n=26) prognosis. Baseline ceCT, [18F]FDG and [89Zr]Zr-DFO-girentuximab-PET/CT were performed. Primary endpoint was the time to disease progression warranting systemic treatment. Maximum standardized uptake values (SUVmax) were measured using lesions on CT-images co-registered to PET/CT. High and low-uptake groups were defined based on median geometric mean SUVmax of RECIST-measurable lesions across patients.RESULTS: The median WW-time was 16.1 months (95%CI 9.0-31.7). The median WW-period was shorter in patients with high [18F]FDG-tumor-uptake than those with low-uptake(9.0 versus 36.2 months, HR 5.6;95%CI 2.4-14.7;p<0.001). Patients with high [89Zr]Zr-DFO-girentuximab-tumor-uptake had a median WW-period of 9.3 months versus 21.3 months with low-uptake (HR 1.7;95%CI 0.9-3.3;p=0.13). Patients with "W&W-criteria" had a longer median WW-period of 21.3 compared with patients without:9.3 months(HR 1.9;95%CI0.9-3.9;pone-sided=0.034). Adding [18F]FDG-uptake to the "W&W-criteria" improved the prediction of WW-duration(p<0.001);whereas [89Zr]Zr-DFO-girentuximab did not (p=0.53).CONCLUSIONS: In patients with good or intermediate risk mccRCC, low [18F]FDG-uptake is associated with prolonged WW. This study shows the predictive value of the "W&W-criteria" for WW duration and shows the potential of [18F]FDG-PET/CT to further improve this.
AB - PURPOSE: Watchful waiting (WW) can be considered for patients with metastatic clear cell renal cell carcinoma (mccRCC) with good or intermediate prognosis, especially those with <2 International Metastatic RCC Database Consortium criteria and ≤2 metastatic sites (referred to as watch and wait ("W&W")-criteria). The IMPACT-RCC study objective was to assess the predictive value of [18F]FDG- and [89Zr]Zr-DFO-girentuximab-PET/CT for WW-duration in patients with mccRCC.PATIENTS AND METHODS: Between February 2015 and March 2018, 48 patients were enrolled, including 40 evaluable patients with good (n=14) and intermediate (n=26) prognosis. Baseline ceCT, [18F]FDG and [89Zr]Zr-DFO-girentuximab-PET/CT were performed. Primary endpoint was the time to disease progression warranting systemic treatment. Maximum standardized uptake values (SUVmax) were measured using lesions on CT-images co-registered to PET/CT. High and low-uptake groups were defined based on median geometric mean SUVmax of RECIST-measurable lesions across patients.RESULTS: The median WW-time was 16.1 months (95%CI 9.0-31.7). The median WW-period was shorter in patients with high [18F]FDG-tumor-uptake than those with low-uptake(9.0 versus 36.2 months, HR 5.6;95%CI 2.4-14.7;p<0.001). Patients with high [89Zr]Zr-DFO-girentuximab-tumor-uptake had a median WW-period of 9.3 months versus 21.3 months with low-uptake (HR 1.7;95%CI 0.9-3.3;p=0.13). Patients with "W&W-criteria" had a longer median WW-period of 21.3 compared with patients without:9.3 months(HR 1.9;95%CI0.9-3.9;pone-sided=0.034). Adding [18F]FDG-uptake to the "W&W-criteria" improved the prediction of WW-duration(p<0.001);whereas [89Zr]Zr-DFO-girentuximab did not (p=0.53).CONCLUSIONS: In patients with good or intermediate risk mccRCC, low [18F]FDG-uptake is associated with prolonged WW. This study shows the predictive value of the "W&W-criteria" for WW duration and shows the potential of [18F]FDG-PET/CT to further improve this.
U2 - 10.1158/1078-0432.CCR-22-0921
DO - 10.1158/1078-0432.CCR-22-0921
M3 - Article
C2 - 36394882
SN - 1078-0432
VL - 29
SP - 592
EP - 601
JO - Clinical Cancer Research
JF - Clinical Cancer Research
IS - 3
ER -