One-month assessment of renal cell carcinoma treated by everolimus using FDG PET/CT predicts progression-free and overall survival.
OBJECTIVE
We evaluated18F-2-fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG PET/CT) results as outcome predictors for patients with metastatic renal cell carcinoma (RCC) treated by everolimus (EVL), an inhibitor of mammalian target of rapamycin.


METHODS
We retrospectively reviewed 30 patients who were treated with EVL for metastatic RCC between May 2010 and March 2015, by evaluating their FDG PET/CT result before and 1 month after starting EVL treatment. We examined the relationships between each patient's maximum standardized uptake value (max SUVmax) assessed by FDG PET/CT on progression-free survival (PFS) and overall survival (OS).


RESULTS
Median PFS for all 30 patients was 3.77 months (range 0.72-24.56 months) and median OS after EVL treatment of all 30 patients was 11.67 months (range 1.0-62.98 months). Enrolled patients were divided into two groups by max SUVmax prior to EVL (median = 7.6) and at 1 month after EVL treatment (median = 5.7). PFS were significantly shorter in higher max SUVmax prior to EVL (<7.6, PFS 7.8 vs 3.5 months, log-rank P = 0.017) and at 1 month after EVL (<5.7, PFS 10.6 vs 2.7 months, log-rank P = 0.002) than lower max SUVmax. OS were also significantly shorter in higher max SUVmax prior to EVL (<7.6, OS 18.1 vs 7.5 months, log-rank P = 0.010) and at 1 month after EVL (<5.7, OS 17.2 vs 7.5 months, log-rank P = 0.009) than lower max SUVmax. Multivariate Cox hazard regression analysis indicated that max SUVmax at 1 month after EVL is an independent predictor of both PFS and OS in patients treated with EVL although univariate regression analysis showed max SUVmax before EVL is a possible predictor.


CONCLUSIONS
Max SUVmax assessed by FDG PET/CT prior to EVL and at 1 month after EVL treatment can accurately predict PFS and can guide decisions on whether to continue or change treatments for patients with EVL-treated RCC who suffer from adverse events.
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Hiroki
H
Ito
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Keiichi
K
Kondo
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Takashi
T
Kawahara
Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Tomohiro
T
Kaneta
Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Ukihide
U
Tateishi
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Daiki
D
Ueno
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Kazuhiro
K
Namura
Department of Urology, Yokosuka Kyosai Hospital, Yokosuka, Japan.
Kazuki
K
Kobayashi
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Yasuhide
Y
Miyoshi
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Yasushi
Y
Yumura
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Kazuhide
K
Makiyama
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Narihiko
N
Hayashi
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Hisashi
H
Hasumi
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Kimito
K
Osaka
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Yumiko
Y
Yokomizo
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Jun-Ichi
JI
Teranishi
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Yusuke
Y
Hattori
Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Tomio
T
Inoue
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Hiroji
H
Uemura
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Masahiro
M
Yao
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan. nakaigan@med.yokohama-cu.ac.jp.
Noboru
N
Nakaigawa
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D018572:Disease-Free Survival; D000068338:Everolimus / Q000627:therapeutic use*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D000072078:Positron Emission Tomography Computed Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D000068338:Everolimus
Early assessment; Everolimus; FDG PET/CT; Predictive biomarker; Renal cell carcinoma