Evaluating Sunitinib Therapy in Renal Cell Carcinoma Using F-18 FDG PET/CT and DCE MRI
|Kidney Neoplasms Carcinoma, Renal Cell Kidney (Renal Cell) Cancer||Procedure: FDG PET CT Procedure: DCE MRI Drug: F-18 Fluoro-deoxi-glucose Drug: Gadolinium-DTPA Drug: Sunitinib|
|Study Design:||Intervention Model: Single Group Assignment
Masking: No masking
Primary Purpose: Diagnostic
|Official Title:||Evaluating Sunitinib Therapy in Renal Cell Carcinoma Using F-18 FDG PET/CT and DCE MRI|
- F-18 FDG Tumor Uptake (SUV Max) [ Time Frame: 12 weeks minus baseline ]
The maximum standardized uptake value (SUVmax) is a measurement of tumor metabolism as determined by the PET scan before and after 12-weeks of sunitinib therapy. Decreased SUVmax correlates to a reduction of tumor metabolism. Increased SUVmax correlates to an increase in tumor metabolism.
Reduction or increased SUVmax will be determined as the change from baseline in uptake of F18 FDG.
Results were based on the European Organization for Research and Treatment of Cancer (EORTC) for predicting progression free survival. EORTC criteria is a ± 25% change of SUVmax for assessment of progressive disease, stable disease and partial response.
- Histopathology [ Time Frame: 1 day ]Histopathologic findings were correlated to the pre-treatment 18F-fluorodeoxyglucose positron emission tomography (F-18 FDG PET/CT) scan. Outcome is reported as the number of participants for whom both histopathology and F-18 FDG PET/CT indicated that active cancers was present.
- Initial Comprehensive Metabolic Panel [ Time Frame: Prior to baseline DCE MRI ]A comprehensive metabolic panel is a blood test that measures sugar (glucose) level, electrolyte and fluid balance, kidney function, and liver function. It was performed prior to the administration of gadolinium contrast. For patients with normal renal function, approximately 90% of gadolinium contrast is excreted through the urinary system. These patients have known renal cell carcinoma, so it was important to perform a metabolic function panel prior to gadolinium injection, specifically to determine kidney function. Reported as the number of patients for whom the initial comprehensive metabolic panel was within institutional standards.
- Adverse Events [ Time Frame: up to 12 months ]Adverse events were monitored for on F-18 FDG PET/CT and DCE MRI imaging days: baseline (n=17); interim (n=12); and post-sunitinib therapy (n=17). Reported as the overall number of adverse events experienced.
- Tumor Necrosis [ Time Frame: 12 weeks ]The degree of tumor necrosis was measured using values obtained from dynamic contrast enhanced magnetic resonance imaging (DCE MRI) pre- and post-sunitinib therapy. Gadolinium contrast material given intravenously during the DCE MRI scan is used to improve visualization of blood vessels, tumors, and/or organs.
- Tumor Size by Computed Tomography (CT) Scan [ Time Frame: 12 weeks ]Tumor size was measured based on computed tomography (CT) pre- and post-sunitinib therapy. CT was performed immediately prior to the PET scan and is used to determine both the PET scan imaging area and PET image attenuation correction (AC). F-18 FDG PET provides the metabolic and physiologic data while CT provides the anatomical data.
- Tumor Size by DCE Magnetic Resonance Imaging (MRI) Scan [ Time Frame: 12 weeks ]Tumor size was measured using values obtained from DCE MRI pre- and post-sunitinib therapy. Gadolinium contrast material given intravenously during the DCE MRI scan is used to improve visualization of blood vessels, tumors, and/or organs.
- DCE MRI AUC Peak Flow [ Time Frame: 12 weeks ]Area under the curve (AUC) was measured using receiver operating characteristic (ROC) curve analysis. ROC curve analysis measures sensitivity (true-positives, correctly diagnosed positive pathologies) against specificity (true-negatives, correctly diagnosed negative pathologies or free of disease) of the DCE MRI scan. An area of 1.0 under the curve would equal a perfect test (with 100% sensitivity; 100% specificity) while an area of 0.5 would equal a useless test (50% sensitivity; 50% specificity).
- Initial Tumor Size [ Time Frame: pre-sunitinib therapy ]Initial tumor size was measured using values obtained from computed tomography (CT) pre-sunitinib therapy. CT is performed immediately prior to the PET scan and is used to determine both the PET scan imaging area and PET image attenuation correction (AC). F-18 FDG PET provides the metabolic and physiologic data while CT provides the anatomical data.
|Study Start Date:||October 2007|
|Study Completion Date:||April 2012|
|Primary Completion Date:||October 2011 (Final data collection date for primary outcome measure)|
Experimental: F-18 FDG PET/CT and DCE MRI
FDG PET CT F-18 Fluoro-deoxi-glucose: 15 mCi iv Gadolinium-DTPA: 0.1 mmol/kg Sunitinib: 50 mg/day po
Procedure: FDG PET CT
nuclear medicine imaging technique which produces a three-dimensional image or picture of functional processes in the body
Other Name: Positron emission tomography (PET)Procedure: DCE MRI
DCE MRI will be acquired using rapid intravenous bolus of gadolinium-DTPA (0.1 mmol/kg).
Other Name: Magnetic Resonance ImagingDrug: F-18 Fluoro-deoxi-glucose
15 mCi iv
Other Names:Drug: Gadolinium-DTPA
0.1 mmol/kg iv
Other Names:Drug: Sunitinib
50 mg/day po
This is a single arm prospective trial in patients with newly-diagnosed advanced renal cell cancer (RCC) who were scheduled for sunitinib therapy and utilized an extensive panel of quantitative metrics on baseline and interim FDG PET/CT to evaluate the predictive utility of each of these measurements.
The objectives were to evaluate the FDG PET/CT measurement parameters for prediction of prognosis after sunitinib therapy in patients with RCC using histopathologic (post-therapy nephrectomy) or clinical follow-up for validation.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00537056
|United States, California|
|Stanford University School of Medicine|
|Stanford, California, United States, 94305|
|Principal Investigator:||Dr Andrew Quon||Stanford University|