Piyush Aggarwal, Harmandeep Singh, Chandan K. Das, Ravimohan S. Mavuduru, Anupam Lal, Nandita Kakkar, Rajender Kumar, Ujjwal Gorsi, Pratibha Prashar, Bhagwant R. Mittal
{"title":"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","authors":"Piyush Aggarwal, Harmandeep Singh, Chandan K. Das, Ravimohan S. Mavuduru, Anupam Lal, Nandita Kakkar, Rajender Kumar, Ujjwal Gorsi, Pratibha Prashar, Bhagwant R. Mittal","doi":"10.1007/s40336-024-00627-2","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>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 <sup>68</sup>Ga-PSMA-11 PET/CT.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>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. <sup>68</sup>Ga-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.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>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.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Early response assessment with <sup>68</sup>Ga-PSMA-11 PET/CT is feasible and provides more accurate prognostic information than CECT in metastatic clear cell RCC patients undergoing targeted therapy.</p><p>Trial registration number</p><p>CTRI/2021/05/033805 (date of registration: 25/05/21)</p>","PeriodicalId":48600,"journal":{"name":"Clinical and Translational Imaging","volume":"10 1","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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\",\"authors\":\"Piyush Aggarwal, Harmandeep Singh, Chandan K. Das, Ravimohan S. Mavuduru, Anupam Lal, Nandita Kakkar, Rajender Kumar, Ujjwal Gorsi, Pratibha Prashar, Bhagwant R. Mittal\",\"doi\":\"10.1007/s40336-024-00627-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Purpose</h3><p>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 <sup>68</sup>Ga-PSMA-11 PET/CT.</p><h3 data-test=\\\"abstract-sub-heading\\\">Methods</h3><p>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. <sup>68</sup>Ga-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.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>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.</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusion</h3><p>Early response assessment with <sup>68</sup>Ga-PSMA-11 PET/CT is feasible and provides more accurate prognostic information than CECT in metastatic clear cell RCC patients undergoing targeted therapy.</p><p>Trial registration number</p><p>CTRI/2021/05/033805 (date of registration: 25/05/21)</p>\",\"PeriodicalId\":48600,\"journal\":{\"name\":\"Clinical and Translational Imaging\",\"volume\":\"10 1\",\"pages\":\"\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-04-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical and Translational Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s40336-024-00627-2\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Translational Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40336-024-00627-2","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
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
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)
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.
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