Related Experiment Video
Updated: May 4, 2026
A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
Assessing the response to targeted therapies in renal cell carcinoma: technical insights and practical considerations
Axel Bex1, Laure Fournier2, Nathalie Lassau3
1Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Context:
The introduction of targeted agents for the treatment of renal cell carcinoma (RCC) has resulted in new challenges for assessing response to therapy, and conventional response criteria using computed tomography (CT) are limited. It is widely recognised that targeted therapies may lead to significant necrosis without significant reduction in tumour size. In addition, the vascular effects of antiangiogenic therapy may occur long before there is any reduction in tumour size.
Objective:
To perform a systematic review of conventional and novel imaging methods for the assessment of response to targeted agents in RCC and to discuss their use from a clinical perspective.
Evidence Acquisition:
Relevant databases covering the period January 2006 to April 2013 were searched for studies reporting on the use of anatomic and functional imaging techniques to predict response to targeted therapy in RCC. Inclusion criteria were randomised trials, nonrandomised controlled studies, retrospective case series, and cohort studies. Reviews, animal and preclinical studies, case reports, and commentaries were excluded. A narrative synthesis of the evidence is presented.
Evidence Synthesis:
A total of 331 abstracts and 76 full-text articles were assessed; 34 studies met the inclusion criteria. Current methods of response assessment in RCC include anatomic methods--based on various criteria including Choi, size and attenuation CT, and morphology, attenuation, size, and structure--and functional techniques including dynamic contrast-enhanced (DCE) CT, DCE-magnetic resonance imaging, DCE-ultrasonography, positron emission tomography, and approaches utilising radiolabelled monoclonal antibodies.
Conclusions:
Functional imaging techniques are promising surrogate biomarkers of response in RCC and may be more appropriate than anatomic CT-based methods. By enabling quantification of tumour vascularisation, functional techniques can directly and rapidly detect the biologic effects of antiangiogenic therapies compared with the indirect detection of belated effects on tumour size by anatomic methods. However, larger prospective studies are needed to validate early results and standardise techniques.
Insights
Functional imaging shows promise for assessing targeted therapy response in renal cell carcinoma (RCC), offering earlier detection of treatment effects than traditional CT scans. Further studies are needed to validate these advanced techniques for clinical use.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- Targeted agents for renal cell carcinoma (RCC) present challenges for conventional response assessment using computed tomography (CT).
- Traditional CT criteria are limited as targeted therapies can cause necrosis without significant tumor shrinkage.
- Antiangiogenic therapies' vascular effects may precede measurable changes in tumor size.
Purpose of the Study:
- To systematically review imaging methods for assessing response to targeted agents in RCC.
- To evaluate conventional and novel imaging techniques from a clinical perspective.
Main Methods:
- A systematic literature search was conducted for studies published between January 2006 and April 2013.
- Inclusion criteria encompassed randomized trials, controlled studies, case series, and cohort studies evaluating imaging techniques for RCC targeted therapy response.
- A narrative synthesis of the evidence was presented.
Main Results:
- 34 studies met the inclusion criteria out of 331 abstracts and 76 full-text articles assessed.
- Current RCC response assessment includes anatomic methods (e.g., Choi criteria, size and attenuation CT) and functional techniques.
- Functional techniques include dynamic contrast-enhanced (DCE) CT/MRI/ultrasonography, positron emission tomography, and radiolabeled monoclonal antibodies.
Conclusions:
- Functional imaging techniques show potential as surrogate biomarkers for RCC response, possibly surpassing anatomic CT-based methods.
- Functional imaging directly quantifies tumor vascularization, rapidly detecting biologic effects of antiangiogenic therapies.
- Larger prospective studies are required to validate these findings and standardize functional imaging techniques.
