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The radiogenomic risk score stratifies outcomes in a renal cell cancer phase 2 clinical trial
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2016 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 26, no 8, 2798-2807 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To characterize a radiogenomic risk score (RRS), a previously defined biomarker, and to evaluate its potential for stratifying radiological progression-free survival (rPFS) in patients with metastatic renal cell carcinoma (mRCC) undergoing pre-surgical treatment with bevacizumab.

METHODOLOGY: In this IRB-approved study, prospective imaging analysis of the RRS was performed on phase II clinical trial data of mRCC patients (n = 41) evaluating whether patient stratification according to the RRS resulted in groups more or less likely to have a rPFS to pre-surgical bevacizumab prior to cytoreductive nephrectomy. Survival times of RRS subgroups were analyzed using Kaplan-Meier survival analysis.

RESULTS: The RRS is enriched in diverse molecular processes including drug response, stress response, protein kinase regulation, and signal transduction pathways (P < 0.05). The RRS successfully stratified rPFS to bevacizumab based on pre-treatment computed tomography imaging with a median progression-free survival of 6 versus >25 months (P = 0.005) and overall survival of 25 versus >37 months in the high and low RRS groups (P = 0.03), respectively. Conventional prognostic predictors including the Motzer and Heng criteria were not predictive in this cohort (P > 0.05).

CONCLUSIONS: The RRS stratifies rPFS to bevacizumab in patients from a phase II clinical trial with mRCC undergoing cytoreductive nephrectomy and pre-surgical bevacizumab.

KEY POINTS: • The RRS SOMA stratifies patient outcomes in a phase II clinical trial. • RRS stratifies subjects into prognostic groups in a discrete or continuous fashion. • RRS is biologically enriched in diverse processes including drug response programs.

Place, publisher, year, edition, pages
2016. Vol. 26, no 8, 2798-2807 p.
Keyword [en]
Radiogenomics, Imaging surrogate, Renal cell carcinoma, Imaging biomarker, Bevacizumab
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:umu:diva-121214DOI: 10.1007/s00330-015-4082-8ISI: 000379192500043PubMedID: 26560727OAI: oai:DiVA.org:umu-121214DiVA: diva2:931589
Available from: 2016-05-30 Created: 2016-05-30 Last updated: 2016-09-07Bibliographically approved

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Ljungberg, Börje
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