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Deoxyribonucleic acid content and medroxyprogesterone acetate treatment in metastatic renal cell carcinoma
1Department of Urology, University of Umeå, Sweden.
Abstract:
High dose medroxyprogesterone treatment was given to 20 patients with metastatic renal cell carcinoma. Distant metastases occurred before the perifascial nephrectomy in 11 patients and following nephrectomy in 9. Tumor deoxyribonucleic acid content was analyzed by flow cytometry in 8 fresh samples from each primary tumor. Four patients had homogeneously diploid primary tumors, 5 had tumors with diploid and aneuploid samples, and all 8 tumor samples were aneuploid in 10 patients. Deoxyribonucleic acid analysis was unsuccessful in 1 patient. One patient with a diploid primary tumor died of an intercurrent disease. Three patients (16 per cent) had objective remissions and 1 had a long-lasting stable disease. Of the 4 patients with any response to medroxyprogesterone acetate treatment 3 had diploid primary tumors, and 1 had 8 diploid and 2 aneuploid samples in the primary tumor. The remaining 14 patients showed no response to treatment and had progressive disease (11 of these patients died within 14 months). All 14 patients had aneuploid primary tumors. The results indicate that tumor ploidy might be related to response to medroxyprogesterone acetate treatment. Deoxyribonucleic acid content seems to be an important parameter to consider in planning treatment of metastatic renal cell carcinoma.
Insights
High-dose medroxyprogesterone acetate treatment showed potential in metastatic renal cell carcinoma. Tumor deoxyribonucleic acid (DNA) content, specifically ploidy, may predict treatment response in these patients.
Area of Science:
- Oncology
- Medical Genetics
Background:
- Metastatic renal cell carcinoma (mRCC) presents a therapeutic challenge.
- High-dose medroxyprogesterone acetate (MPA) has been investigated for mRCC treatment.
- Tumor deoxyribonucleic acid (DNA) content, or ploidy, is a characteristic of cancer cells.
Purpose of the Study:
- To evaluate the efficacy of high-dose MPA in patients with mRCC.
- To investigate the correlation between tumor DNA content (ploidy) and response to MPA treatment in mRCC.
Main Methods:
- Twenty patients with mRCC received high-dose MPA.
- Tumor DNA content was analyzed using flow cytometry on primary tumor samples.
- Patient response was assessed based on objective remission and disease stability.
Main Results:
- Three patients (16%) achieved objective remission, and one had stable disease.
- Patients with diploid primary tumors showed a higher response rate to MPA.
- All 14 non-responding patients had aneuploid primary tumors.
Conclusions:
- Tumor ploidy may be a significant predictive factor for MPA treatment response in mRCC.
- DNA content analysis could aid in treatment planning for patients with metastatic renal cell carcinoma.