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Updated: Jun 19, 2026
A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
Optimizing the size variation threshold for the CT evaluation of response in metastatic renal cell carcinoma treated
R Thiam1, L S Fournier, L Trinquart
1Department of Radiology, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris Descartes University, Paris, France.
Background:
In metastatic renal cell carcinoma (mRCC), antiangiogenic treatments rarely achieve a reduction of -30% in the sum of longest diameters (SLD) of target lesions required by RECIST for an 'objective response', although they objectively improve progression-free survival (PFS). We sought to determine a threshold for the computed tomography evaluation of these patients' best reflecting patient outcome.
Patients And Methods:
In 334 mRCC patients treated with sunitinib, we tested thresholds from -45% to +10%. We classified patients as 'responders' when the best relative variation of the sum of longest diameters (DeltaSLD) reached the tested threshold and as 'nonresponders' otherwise. For each tested threshold, the median PFS of the two groups were compared. Receiver operating characteristic (ROC) analysis was also carried out among the 103 patients that progressed during follow-up. Finally, the 'optimal' threshold was retested on an independent cohort of 39 patients.
Results:
The DeltaSLD threshold of -10% gave the most significant difference. It divided patients into 256 responders and 78 nonresponders (median PFS 11.1 and 5.6 months). The same -10% threshold was found using the ROC analysis. Results were confirmed on the external validation cohort.
Conclusion:
A variation of -10% in the SLD accurately and rapidly identifies mRCC patients benefiting from sunitinib.
Insights
A -10% change in tumor size (DeltaSLD) effectively identifies metastatic renal cell carcinoma (mRCC) patients who benefit from sunitinib treatment, offering a more sensitive measure than standard RECIST criteria.
Area of Science:
- Oncology
- Medical Imaging
- Pharmacology
Background:
- Metastatic renal cell carcinoma (mRCC) antiangiogenic treatments often fail to meet RECIST criteria for objective response.
- Progression-free survival (PFS) is often improved despite lack of RECIST-defined response.
- There is a need for more sensitive imaging evaluation metrics in mRCC.
Purpose of the Study:
- To determine an optimal computed tomography (CT) evaluation threshold for mRCC patients treated with sunitinib.
- To identify a best reflecting patient outcome metric beyond standard RECIST criteria.
Main Methods:
- 334 mRCC patients treated with sunitinib were analyzed.
- Tumor size variation (DeltaSLD) thresholds from -45% to +10% were tested.
- Progression-free survival (PFS) was compared between 'responders' and 'nonresponders' at each threshold. ROC analysis and external validation were performed.
Main Results:
- A DeltaSLD threshold of -10% showed the most significant difference in PFS.
- Patients with -10% DeltaSLD had a median PFS of 11.1 months versus 5.6 months for others.
- This -10% threshold was validated in an independent cohort.
Conclusions:
- A -10% variation in the sum of longest diameters (SLD) accurately identifies mRCC patients benefiting from sunitinib.
- This metric provides a rapid and reliable assessment of treatment efficacy.
- The findings suggest a revised imaging evaluation approach for mRCC.
