title: mTOR-inhibitor treatment of metastatic renal cell carcinoma: contribution of Choi and modified Choi criteria assessed in 2D or 3D to evaluate tumor response.
abstract: OBJECTIVE
  To determine whether 2D or 3D Choi and modified Choi (mChoi) criteria could assess the efficacy of everolimus against metastatic renal cell carcinoma (mRCC).
  
  
  METHODS
  RECIST-1.1, Choi, and mChoi criteria were applied retrospectively to analyse baseline and 2-month contrast-enhanced computed tomography (CECT) images in 48 patients with mRCC enrolled in the everolimus arm of the French randomized double-blind multicentre phase III trial comparing everolimus versus placebo (RECORD-1). The primary endpoint was centrally reviewed progression-free survival (PFS) calculated from the initial RECORD-1 analysis. Mean attenuation was determined for 2D target lesion regions of interest drawn on CECT sections whose largest diameters had been measured, and for the 3D whole target lesion.
  
  
  RESULTS
  The median PFS was 5.5 months. The median PFS for everolimus responders defined using 3D mChoi criteria was significantly longer than for non-responders (7.6 versus 5.4 months, respectively), corresponding to a hazard ratio for progression of 0.45 (95 % CI: 0.22-0.92), with respective 1-year survival rates of 31 % and 9 %. No other 2D or 3D imaging criteria at 2 months identified patients who would benefit from everolimus.
  
  
  CONCLUSIONS
  At 2 months, only 3D mChoi criteria were able to identify mRCC patients with a PFS benefit from everolimus.
  
  
  CONCLUSIONS
  Choi criteria could not identify everolimus-treated patients with significantly prolonged PFS. mCHOI enabled identification of everolimus-treated mRCC patients with a PFS benefit. 3D attenuation measurement criteria appeared to perform better than single-slice measurement.
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, F-75013, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Lamuraglia
authors.affiliation: Service de Radiologie Polyvalente et Oncologique, Groupe Hospitalier Pitié-Salpêtrière, APHP UPMC, 47-83, Bd de l'Hôpital, 75651, Paris Cedex 13, France.
authors.forename: S
authors.initials: S
authors.lastname: Raslan
authors.affiliation: Oncology Unit, Georges-Pompidou Hospital, APHP, Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Elaidi
authors.affiliation: Oncology Unit, Georges-Pompidou Hospital, APHP, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Oudard
authors.affiliation: Medical Oncology Department, Gustave-Roussy Institute, Villejuif, France.
authors.forename: B
authors.initials: B
authors.lastname: Escudier
authors.affiliation: Novartis Pharma, Rueil-Malmaison, France.
authors.forename: K
authors.initials: K
authors.lastname: Slimane
authors.affiliation: Service de Radiologie Polyvalente et Oncologique, Groupe Hospitalier Pitié-Salpêtrière, APHP UPMC, 47-83, Bd de l'Hôpital, 75651, Paris Cedex 13, France.
authors.forename: R Renard
authors.initials: RR
authors.lastname: Penna
authors.affiliation: Service de Radiologie Polyvalente et Oncologique, Groupe Hospitalier Pitié-Salpêtrière, APHP UPMC, 47-83, Bd de l'Hôpital, 75651, Paris Cedex 13, France.
authors.forename: M
authors.initials: M
authors.lastname: Wagner
authors.affiliation: Service de Radiologie Polyvalente et Oncologique, Groupe Hospitalier Pitié-Salpêtrière, APHP UPMC, 47-83, Bd de l'Hôpital, 75651, Paris Cedex 13, France. olivier.lucidarme@psl.aphp.fr.|Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, F-75013, Paris, France. olivier.lucidarme@psl.aphp.fr.
authors.forename: O
authors.initials: O
authors.lastname: Lucidarme
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D018572:Disease-Free Survival; D004311:Double-Blind Method; D000068338:Everolimus / Q000627:therapeutic use*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D021621:Imaging, Three-Dimensional; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020123:Sirolimus / Q000627:therapeutic use*; D015996:Survival Rate / Q000639:trends; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases; D020123:Sirolimus
keywords: 3D imaging; Computed tomography; Neoplasm metastasis; Renal cell carcinoma; Tumour response