To predict progression-free survival and overall survival in metastatic renal cancer treated with sorafenib: pilot study using dynamic contrast-enhanced Doppler ultrasound.
BACKGROUND
The objective of this study was to evaluate dynamic contrast-enhanced Doppler ultrasound (DCE-US) with perfusion software (Vascular Recognition Imaging) and contrast agent injection as a predictor of tumour response, progression-free survival (PFS) and overall survival (OS).


METHODS
Thirty patients with a metastatic renal cell carcinoma (RCC) already enrolled in a double-blind randomised study were evaluated. Examinations were performed at baseline, and after 3 and 6 weeks on sorafenib or a placebo in patients with tumour targets that were accessible to DCE-US.


RESULTS
A total of 85 examinations were performed, 30 at baseline, 28 at 3 weeks and 27 at 6 weeks. The combination of a decrease in contrast uptake exceeding 10% and stability or a decrease in tumour volume allowed us to discriminate seven good responders and 20 poor responders at 3 weeks. There was a statistically significant difference in PFS (p=10(-4)) and OS (p=10(-4)) between good and poor responders.


CONCLUSIONS
DCE-US is a new noninvasive imaging technique which might be an effective tool for evaluating antiangiogenic drugs in renal cancer.
Lamuraglia
Michele
M
Department of Medical Imaging, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif, France.
Escudier
Bernard
B
Chami
Linda
L
Schwartz
Brian
B
Leclère
Jérome
J
Roche
Alain
A
Lassau
Nathalie
N
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001557:Benzenesulfonates / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000188:drug therapy; D003287:Contrast Media; D018450:Disease Progression; D018572:Disease-Free Survival; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D010743:Phospholipids; D010865:Pilot Projects; D011725:Pyridines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D000077157:Sorafenib; D013459:Sulfur Hexafluoride; D016019:Survival Analysis; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods*
D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D003287:Contrast Media; D010671:Phenylurea Compounds; D010743:Phospholipids; D011725:Pyridines; C420843:contrast agent BR1; D009536:Niacinamide; D000077157:Sorafenib; D013459:Sulfur Hexafluoride