Metastatic renal cell carcinoma treated with sunitinib: early evaluation of treatment response using dynamic contrast-enhanced ultrasonography.
OBJECTIVE
To determine the utility of dynamic contrast-enhanced ultrasonography (DCE-US) as a prognostic tool for metastatic renal cell carcinoma patients receiving sunitinib and to identify DCE-US parameters that correlate with early treatment response.


METHODS
Thirty-eight patients received 50 mg/d sunitinib on schedule 4/2 (4 weeks on followed by 2 weeks off treatment). After two cycles, response evaluation criteria in solid tumors were used to classify patients as responders or nonresponders. DCE-US evaluations were done before treatment and at day 15; variations between days 0 and 15 were calculated for seven DCE-US functional parameters and were compared for responders and nonresponders. The correlation between DCE-US parameters and disease-free survival (DFS) and overall survival (OS) was assessed.


RESULTS
The ratio between DCE-US examinations at baseline and day 15 significantly correlated with response in five of the seven DCE-US parameters. Two DCE-US parameters (time to peak intensity and slope of the wash-in) were significantly associated with DFS; time to peak intensity was also significantly associated with OS.


CONCLUSIONS
DCE-US is a useful tool for predicting the early efficacy of sunitinib in metastatic renal cell carcinoma patients. Robust correlations were observed between functional parameters and classic assessments, including DFS and OS.
Lassau
Nathalie
N
Imaging Department, Service of Biostatistics and Epidemiology, and Medical Department, Institut Gustave Roussy, Villejuif Cedex, France. lassau@igr.fr
Koscielny
Serge
S
Albiges
Laurence
L
Chami
Linda
L
Benatsou
Baya
B
Chebil
Mohamed
M
Roche
Alain
A
Escudier
Bernard J
BJ
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D003287:Contrast Media; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D009362:Neoplasm Metastasis; D011379:Prognosis; D011758:Pyrroles / Q000627:therapeutic use*; D000077210:Sunitinib; D014463:Ultrasonography / Q000379:methods*
D000970:Antineoplastic Agents; D003287:Contrast Media; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib