[89Zr]Zr-DFO-girentuximab and [18F]FDG PET/CT to predict watchful waiting duration in patients with metastatic clear cell renal cell carcinoma.

Abstract

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.

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.

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).

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.

More about this publication

Clinical cancer research : an official journal of the American Association for Cancer Research
  • Publication date 17-11-2022

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