OBJECTIVE: Anti-angiogenic drugs cause a reduction in tumour density (Choi criteria) first and then in size [Response Evaluation Criteria In Solid Tumours (RECIST)].
The prognostic significance of changes in tumour density in metastatic renal cell carcinoma (mRCC) is unknown and was assessed in this study.
METHODS: The prognostic significance of partial response (PR) as opposed to non-response [stable disease (SD) + progressive (PD)] to anti-angiogenic therapy was assessed in patients with mRCC separately for both criteria using the log-rank test and Cox regression models.
RESULTS: Both criteria were applied to 35 patients. The response was identical for all eight patients with PR and most patients with PD (10/12) when using the RECIST and Choi criteria. Adding tumour density information, 14 patients with SD were re-categorised as having PR (7), SD (4), and PD (3). Patients with PR (Choi) were progression free significantly longer [hazard ratio (HR) 0.24; 95 % CI 0.10-0.57; P = 0.001] and had better overall survival (HR 0.36; 95 % CI 0.15-0.89; P = 0.026) compared to patients with SD or PD. The predictive value of PR according to RECIST was not statistically significant.
CONCLUSIONS: In mRCC, the Choi criteria separate prognostic groups better when compared with RECIST. This may allow early discrimination of patients benefiting from continued treatment.
Written by:
Schmidt N, Hess V, Zumbrunn T, Rothermundt C, Bongartz G, Potthast S. Are you the author?
Department of Radiology and Nuclear Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
Reference: Eur Radiol. 2012 Aug 24. Epub ahead of print.
doi: 10.1007/s00330-012-2640-x
PubMed Abstract
PMID: 22918564
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