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Tang S, Fan T, Wang X, Yu C, Zhang C, Zhou Y. Cancer Immunotherapy and Medical Imaging Research Trends from 2003 to 2023: A Bibliometric Analysis. J Multidiscip Healthc 2024; 17:2105-2120. [PMID: 38736544 PMCID: PMC11086400 DOI: 10.2147/jmdh.s457367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/16/2024] [Indexed: 05/14/2024] Open
Abstract
Purpose With the rapid development of immunotherapy, cancer treatment has entered a new phase. Medical imaging, as a primary diagnostic method, is closely related to cancer immunotherapy. However, until now, there has been no systematic bibliometric analysis of the state of this field. Therefore, the main purpose of this article is to clarify the past research trajectory, summarize current research hotspots, reveal dynamic scientific developments, and explore future research directions. Patients and Methods A comprehensive search was conducted on the Web of Science Core Collection (WoSCC) database to identify publications related to immunotherapy specifically for the medical imaging of carcinoma. The search spanned the period from the year 2003 to 2023. Several analytical tools were employed. These included CiteSpace (6.2.4), and the Microsoft Office Excel (2016). Results By searching the database, a total of 704 English articles published between 2003 and 2023 were obtained. We have observed a rapid increase in the number of publications since 2018. The two most active countries are the United States (n=265) and China (n=170). Pittock, Sean J and Abu-sbeih, Hamzah are very concerned about the relationship between cancer immunotherapy and medical images and have published more academic papers (n = 5; n = 4). Among the top 10 co-cited authors, Topalian Sl (n=43) cited ranked first, followed by Graus F (n=40) cited. According to clustering, timeline, and burst word analysis, the results show that the current research focus is on "MRI", "deep learning", "tumor microenvironment" and so on. Conclusion Medical imaging and cancer immunotherapy are hot topics. The United States is the country with the most publications and the greatest influence in this field, followed by China. "MRI", "PET/PET-CT", "deep learning", "immune-related adverse events" and "tumor microenvironment" are currently hot research topics and potential targets.
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Affiliation(s)
- Shuli Tang
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150010, People’s Republic of China
| | - Tiantian Fan
- Department of Radiology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150010, People’s Republic of China
| | - Xinxin Wang
- Department of Radiology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150010, People’s Republic of China
| | - Can Yu
- Department of Radiology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150010, People’s Republic of China
| | - Chunhui Zhang
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150010, People’s Republic of China
| | - Yang Zhou
- Department of Radiology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150010, People’s Republic of China
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Larrinaga G, Valdivia A, Arrieta-Aguirre I, Solano-Iturri JD, Ugalde-Olano A, Loizaga-Iriarte A, Santos-Martín A, Pérez-Fernández A, Angulo JC, López JI. The Expression of Alamandine Receptor MrgD in Clear Cell Renal Cell Carcinoma Is Associated with a Worse Prognosis and Unfavorable Response to Antiangiogenic Therapy. Int J Mol Sci 2024; 25:1499. [PMID: 38338778 PMCID: PMC10855800 DOI: 10.3390/ijms25031499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Renal cell carcinoma (RCC) ranks among the most prevalent malignancies in Western countries, marked by its notable heterogeneity, which contributes to an unpredictable clinical trajectory. The insufficiency of dependable biomarkers adds complexity to assessing this tumor progression. Imbalances of several components of the intrarenal renin-angiotensin system (iRAS) significantly impact patient prognoses and responses to first-line immunotherapies. In this study, we analyzed the immunohistochemical expression of the Mas-related G-protein-coupled receptor D (MrgD), which recognizes the novel RAS peptide alamandine (ALA), in a series of 87 clear cell renal cell (CCRCCs), 19 papillary (PRCC), 7 chromophobe (ChRCC) renal cell carcinomas, and 11 renal oncocytomas (RO). MrgD was expressed in all the renal tumor subtypes, with a higher mean staining intensity in the PRCCs, ChRCCs, and ROs. A high expression of MrgD at the tumor center and at the infiltrative front of CCRCC tissues was significantly associated with a high histological grade, large tumor diameter, local invasion, and locoregional node and distant metastasis. Patients with worse 5-year cancer-specific survival and a poorer response to antiangiogenic tyrosine-kinase inhibitors (TKIs) showed higher MrgD expression at the center of their primary tumors. These findings suggest a possible role of MrgD in renal carcinogenetic processes. Further studies are necessary to unveil its potential as a novel biomarker for CCRCC prognosis and response to frontline therapies.
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Affiliation(s)
- Gorka Larrinaga
- Department of Nursing, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain;
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
- Biobizkaia Health Research Institute, 48903 Barakaldo, Spain; (J.D.S.-I.); (A.U.-O.); (A.L.-I.); (A.S.-M.); (A.P.-F.); (J.I.L.)
| | - Asier Valdivia
- Department of Cellular Biology and Histology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain;
| | - Inés Arrieta-Aguirre
- Department of Nursing, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain;
| | - Jon Danel Solano-Iturri
- Biobizkaia Health Research Institute, 48903 Barakaldo, Spain; (J.D.S.-I.); (A.U.-O.); (A.L.-I.); (A.S.-M.); (A.P.-F.); (J.I.L.)
- Department of Pathology, Cruces University Hospital, 48903 Barakaldo, Spain
| | - Aitziber Ugalde-Olano
- Biobizkaia Health Research Institute, 48903 Barakaldo, Spain; (J.D.S.-I.); (A.U.-O.); (A.L.-I.); (A.S.-M.); (A.P.-F.); (J.I.L.)
- Department of Pathology, Basurto University Hospital, 48903 Barakaldo, Spain
| | - Ana Loizaga-Iriarte
- Biobizkaia Health Research Institute, 48903 Barakaldo, Spain; (J.D.S.-I.); (A.U.-O.); (A.L.-I.); (A.S.-M.); (A.P.-F.); (J.I.L.)
- Department of Urology, Basurto University Hospital, University of the Basque Country (UPV/EHU), 48013 Bilbao, Spain
| | - Aida Santos-Martín
- Biobizkaia Health Research Institute, 48903 Barakaldo, Spain; (J.D.S.-I.); (A.U.-O.); (A.L.-I.); (A.S.-M.); (A.P.-F.); (J.I.L.)
- Department of Urology, Basurto University Hospital, University of the Basque Country (UPV/EHU), 48013 Bilbao, Spain
| | - Amparo Pérez-Fernández
- Biobizkaia Health Research Institute, 48903 Barakaldo, Spain; (J.D.S.-I.); (A.U.-O.); (A.L.-I.); (A.S.-M.); (A.P.-F.); (J.I.L.)
- Department of Urology, Basurto University Hospital, University of the Basque Country (UPV/EHU), 48013 Bilbao, Spain
| | - Javier C. Angulo
- Clinical Department, Faculty of Medical Sciences, European University of Madrid, 28905 Getafe, Spain;
- Department of Urology, University Hospital of Getafe, 28907 Madrid, Spain
| | - José I. López
- Biobizkaia Health Research Institute, 48903 Barakaldo, Spain; (J.D.S.-I.); (A.U.-O.); (A.L.-I.); (A.S.-M.); (A.P.-F.); (J.I.L.)
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Chen C, Duan X, Shen Y, Li G. The clinical efficacy and safety of TACE combined with apatinib for advanced hepatocellular carcinoma: A propensity score matching analysis. Indian J Cancer 2022; 0:362411. [PMID: 36861715 DOI: 10.4103/ijc.ijc_967_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background The combined treatment of transcatheter arterial chemoembolization (TACE) and apatinib had beneficial effects on the survival of patients with advanced hepatocellular carcinoma (HCC), but the efficacy of this regimen is still controversial and needs further investigation. Materials and Methods The clinical records of advanced HCC patients between May 2015 and December 2016 were collected from our hospital. They were categorized into the TACE monotherapy group and the combination of TACE and apatinib group. After propensity score matching (PSM) analysis, the disease control rate (DCR), objective response rate (ORR), progression-free survival (PFS), and occurrence of adverse events were compared between the two treatments. Results There were 115 HCC patients included in the study. Among them, 53 received TACE monotherapy and 62 were treated with TACE plus apatinib. After PSM analysis, 50 pairs of patients were compared. The DCR of the TACE group was significantly lower than that of the combination of TACE and apatinib group (35 [70%] versus 45 [90%], P < 0.05). The ORR of the TACE group was also significantly lower than that of the combination of TACE and apatinib group (22 [44%] versus 34 [68%], P < 0.05). Patients who received the combined treatment of TACE and apatinib had longer PFS compared with those in the TACE monotherapy group (P < 0.001). Moreover, hypertension, hand-foot syndrome, and albuminuria were more common in the combination of TACE and apatinib group (P < 0.05), although all adverse events were well tolerated. Conclusions The combined treatment of TACE and apatinib showed beneficial effects on tumor response, survival outcomes, and tolerance to treatment, which may be used as a routine regimen for advanced HCC patients.
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Affiliation(s)
- Cheng Chen
- Department of Oncology, Affiliated Hospital of Hebei University of Engineering, Handan, Hebei, People's Republic of China
| | - Xiaoting Duan
- Department of Nephrology, Affiliated Hospital of Hebei University of Engineering, Handan, Hebei, People's Republic of China
| | - Yanfeng Shen
- Department of Oncology, Affiliated Hospital of Hebei University of Engineering, Handan, Hebei, People's Republic of China
| | - Guiying Li
- Department of Nephrology, Affiliated Hospital of Hebei University of Engineering, Handan, Hebei, People's Republic of China
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Chatzaraki V, Born C, Kubik-Huch RA, Froehlich JM, Thali MJ, Niemann T. Influence of Radiation Dose and Reconstruction Kernel on Fat Fraction Analysis in Dual-energy CT: A Phantom Study. In Vivo 2021; 35:3147-3155. [PMID: 34697145 DOI: 10.21873/invivo.12609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The quantitative evaluation of fat tissue, mainly for the determination of liver steatosis, is possible by using dual-energy computed tomography. Different photon energy acquisitions allow for estimation of attenuation coefficients. The effect of variation in radiation doses and reconstruction kernels on fat fraction estimation was investigated. MATERIALS AND METHODS A six-probe-phantom with fat concentrations of 0%, 20%, 40%, 60%, 80%, and 100% were scanned in Sn140/100 kV with radiation doses ranging between 20 and 200 mAs before and after calibration. Images were reconstructed using iterative kernels (I26,Q30,I70). RESULTS Fat fractions measured in dual-energy computed tomography (DECT) were consistent with the 20%-stepwise varying actual concentrations. Variation in radiation dose resulted in 3.1% variation of fat fraction. Softer reconstruction kernel (I26) underestimated the fat fraction (-9.1%), while quantitative (Q30) and sharper kernel (I70) overestimated fat fraction (10,8% and 13,1, respectively). CONCLUSION The fat fraction in DECT approaches the actual fat concentration when calibrated to the reconstruction kerneö. Variation of radiation dose caused an acceptable 3% variation.
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Affiliation(s)
| | - Corinna Born
- Hospital Pharmacy, Kantonsspital Baden, Baden, Switzerland
| | | | | | - Michael J Thali
- Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Tilo Niemann
- Department of Radiology, Kantonsspital Baden, Baden, Switzerland;
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Huicochea Castellanos S, Pagano A, Plodkowski AJ, Girshman J, Hellmann MD, Rizvi H, Flynn J, Zheng J, Capanu M, Halpenny DF, Ginsberg MS. Intra- and inter-reader agreement of iRECIST and RECIST 1.1 criteria for the assessment of tumor response in patients receiving checkpoint inhibitor immunotherapy for lung cancer. Lung Cancer 2021; 161:60-67. [PMID: 34536733 DOI: 10.1016/j.lungcan.2021.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/17/2021] [Accepted: 08/31/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate the inter- and intra-reader agreement of immune Response Evaluation Criteria in Solid Tumors (iRECIST) and Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) in patients with lung cancer treated with immunotherapy. MATERIALS AND METHODS This retrospective study included 85 patients with lung cancer treated with PD-1 blockade. Four radiologists evaluated computed topography (CT) scans before and after initiation of immunotherapy using iRECIST and RECIST 1.1. Weighted kappa (k) with equal weights was used to assess the intra-reader agreement between 2 repeated reads on overall response at all time points, best overall response, and the response at the time point of progression, as well as the intra-reader agreement between iRECIST and RECIST. The inter-reader agreement was calculated using Light's kappa. RESULTS Intra-reader agreement for overall response at all time points, best overall response, and time point of progression was substantial to almost perfect for both iRECIST and RECIST 1.1 (k = 0.651-0.983). Inter-reader agreement was substantial for iRECIST (κ = 0.657-0.742) while RECIST 1.1 was moderate to substantial (κ = 0.587-0.686). The level of inter-reader agreement was not higher on repeat read for iRECIST (κ = 0.677-0.709 and κ = 0.657-0.742 for first and second read, respectively) as well as for RECIST 1.1 (κ = 0.587-0.659 and κ = 0.633-0.686 for first and second read, respectively). Almost perfect agreement was observed between RECIST 1.1 and iRECIST at first (κ = 0.813-0.923) and second read (κ = 0.841-0.912). CONCLUSION The inter- and intra-reader agreement of iRECIST is high and similar to RECIST 1.1 in patients with lung cancer treated with immunotherapy.
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Affiliation(s)
- Sandra Huicochea Castellanos
- Department of Radiology, Weill Cornell Medicine-New York Presbyterian Hospital, New York, NY 10065, United States
| | - Andrew Pagano
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States.
| | - Andrew J Plodkowski
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Jeffrey Girshman
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Matthew D Hellmann
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Hira Rizvi
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Jessica Flynn
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Junting Zheng
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Marinela Capanu
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Darragh F Halpenny
- Department of Radiology, Tallaght University Hospital, Dublin D24 NR04, Ireland
| | - Michelle S Ginsberg
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
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6
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Basso U, Facchinetti A, Rossi E, Maruzzo M, Conteduca V, Aieta M, Massari F, Fraccon AP, Mucciarini C, Sava T, Santoni M, Pegoraro C, Durante E, Nicodemo M, Perin A, Bearz A, Gatti C, Fiduccia P, Diminutto A, Barile C, De Giorgi U, Zamarchi R, Zagonel V. Prognostic Role of Circulating Tumor Cells in Metastatic Renal Cell Carcinoma: A Large, Multicenter, Prospective Trial. Oncologist 2021; 26:740-750. [PMID: 34077597 DOI: 10.1002/onco.13842] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/25/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Circulating tumor cells (CTCs) correlate with adverse prognosis in patients with breast, colorectal, lung, and prostate cancer. Little data are available for renal cell carcinoma (RCC). MATERIALS AND METHODS We designed a multicenter prospective observational study to assess the correlation between CTC counts and progression-free survival (PFS) in patients with metastatic RCC treated with an antiangiogenic tyrosine kinase inhibitor as a first-line regimen; overall survival (OS) and response were secondary objectives. CTC counts were enumerated by the CellSearch system at four time points: day 0 of treatment, day 28, day 56 and then at progression, or at 12 months in the absence of progression. RESULTS One hundred ninety-five eligible patients with a median age of 69 years were treated with sunitinib (77.5%) or pazopanib (21%). At baseline, 46.7% of patients had one or more CTCs per milliliter (range, 1 to 263). Thirty patients had at least three CTCs, with a median PFS of 5.8 versus 15 months in the remaining patients (p = .002; hazard ratio [HR], 1.99), independently of the International Metastatic RCC Database Consortium score at multivariate analysis (HR, 1.91; 95% confidence interval [CI], 1.16-3.14). Patients with at least three CTCs had a shorter estimated OS of 13.8 months versus 52.8 months in those with fewer than three CTCs (p = .003; HR, 1.99; multivariate analysis HR, 1.67; 95% CI, 0.95-2.93). Baseline CTC counts did not correlate with response; neither did having CTC sequencing counts greater than or equal to one, two, three, four, or five. CONCLUSION We provide prospective evidence that the presence of three or more CTCs at baseline is associated with a significantly shorter PFS and OS in patients with metastatic RCC. IMPLICATIONS FOR PRACTICE This prospective study evaluated whether the presence of circulating tumor cells (CTCs) in the peripheral blood correlates with activity of first-line tyrosine kinase inhibitors in metastatic renal cell carcinoma (RCC). This study demonstrated that almost half of patients with metastatic RCC have at least one CTC in their blood and that those patients with at least three CTCs are at increased risk of early progressive disease and early death due to RCC. Studies incorporating CTC counts in the prognostic algorithms of metastatic RCC are warranted.
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Affiliation(s)
- Umberto Basso
- Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Antonella Facchinetti
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy.,Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
| | - Elisabetta Rossi
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy.,Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
| | - Marco Maruzzo
- Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Vincenza Conteduca
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Michele Aieta
- Department of Onco-Hematology, Division of Medical Oncology, Centro di Riferimento Oncologico della Basilicata IRCCS, Rionero in Vulture, Italy
| | - Francesco Massari
- Department of Medical Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.,Medical Oncology, IRCCS Azienda Ospedaliera Universitaria, Bologna, Italy
| | - Anna Paola Fraccon
- Medical Oncology, Ospedale P. Pederzoli, Peschiera Del Garda, Peschiera Del Garda (VR), Italy
| | - Claudia Mucciarini
- Medical Oncology Unit, Ramazzini Hospital, Carpi-AUSL Modena, Modena, Italy
| | - Teodoro Sava
- Medical Oncology, Ospedale Borgo Trento, Verona, Italy
| | - Matteo Santoni
- Medical Oncology, Polytechnic University of the Marche Region, Azienda Ospedaliero-Universitaria, Ospedali Riuniti Umberto I-GM Lancisi and G Salesi, Ancona, Italy
| | - Cristina Pegoraro
- Medical Oncology Ospedale di Montecchio Maggiore, Azienda ULSS 8 Berica, Berica, Italy
| | - Emilia Durante
- Department of Medical Oncology, Ospedale di Legnago, Azienda ULSS 9 Scaligera, Scaligera, Italy
| | - Maurizio Nicodemo
- Department of Medical Oncology, Sacro Cuore - Don Calabria Hospital, Negrar, Italy
| | - Alessandra Perin
- Medical Oncology, Polo Unico Ospedale Santorso, Santorso, Azienda ULSS 7 Pedemontana, Pedemontana, Italy
| | - Alessandra Bearz
- Department of Medical Oncology, Centro Riferimento Oncologico CRO IRCCS, Aviano, Italy
| | - Carlo Gatti
- Medical Oncology, Ospedale di Chioggia, Azienda ULSS 3 Serenissima, Chioggia, Italy
| | - Pasquale Fiduccia
- Clinical Research Unit, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Alberto Diminutto
- Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Carmen Barile
- Medical Oncology, Ospedale di Rovigo, Azienda ULSS 5 Polesana, Rovigo, Italy
| | - Ugo De Giorgi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Rita Zamarchi
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Vittorina Zagonel
- Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
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Yuan P, Wang F, Zhu G, Chen B. The clinical efficiency of TACE combined with simultaneous computed tomography-guided radiofrequency ablation for advanced hepatocellular carcinoma. Invest New Drugs 2021; 39:1383-1388. [PMID: 33754235 DOI: 10.1007/s10637-021-01101-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/12/2021] [Indexed: 02/08/2023]
Abstract
Background To investigate the clinical efficiency of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) for advanced hepatocellular carcinoma (HCC). Methods This retrospective study enrolled 177 HCC patients, and they were divided into TACE monotherapy group (n = 129) and TACE + RFA group (n = 48) between January 2015 and October 2017. The objective response rate (ORR), disease control rate (DCR), and the survival outcomes were compared between the TACE monotherapy and the treatment of TACE + RFA after propensity score matching (PSM). Results After PSM matching, the confounding factors had no significant differences between the 48 pairs of patients. The DCR was calculated as 33 (69 %) and 42 (88 %) for the TACE monotherapy group and TACE + RFA group, respectively (P < 0.05). And the ORR was calculated as 23 (48 %) and 35 (73 %), respectively (P < 0.05). Moreover, the PFS rate of the TACE + RFA group was significantly higher than the TACE alone group (P < 0.001). Conclusions The treatment of TACE combined with RFA has better tumor response rate and survival rate than the TACE monotherapy for patients with advanced HCC.
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Affiliation(s)
- Peng Yuan
- Department of Hematology and Oncology (Key Discipline of Jiangsu Medicine), Medical School, Zhongda Hospital, Southeast University, No. 87 Dingjiaqiao, Gulou District, Jiangsu Province, 210009, Nanjing, People's Republic of China
| | - Fei Wang
- Department of Hematology and Oncology (Key Discipline of Jiangsu Medicine), Medical School, Zhongda Hospital, Southeast University, No. 87 Dingjiaqiao, Gulou District, Jiangsu Province, 210009, Nanjing, People's Republic of China
| | - Guangyu Zhu
- Department of Interventional Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, 210009, Jiangsu Province, People's Republic of China
| | - Baoan Chen
- Department of Hematology and Oncology (Key Discipline of Jiangsu Medicine), Medical School, Zhongda Hospital, Southeast University, No. 87 Dingjiaqiao, Gulou District, Jiangsu Province, 210009, Nanjing, People's Republic of China.
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Abstract
Patients with renal cell carcinoma may develop metastases after radical nephrectomy, and therefore monitoring with imaging for recurrent or metastatic disease is critical. Imaging varies with specific suspected site of disease. Computed tomography/MRI of the abdomen and pelvis are mainstay modalities. Osseous and central nervous system imaging is reserved for symptomatic patients. Radiologic reporting is evolving to reflect effects of systemic therapy on lesion morphology. Nuclear medicine studies compliment routine imaging as newer agents are evaluated for more accurate tumor staging. Imaging research aims to fill gaps in treatment selection and monitoring of treatment response in metastatic renal cell carcinoma.
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Affiliation(s)
- Soumya V L Vig
- Department of Radiology, NYU Langone Medical Center, New York, NY 10016, USA
| | - Elcin Zan
- Department of Radiology, NYU Langone Medical Center, New York, NY 10016, USA
| | - Stella K Kang
- Department of Radiology, NYU Langone Medical Center, New York, NY 10016, USA; Department of Population Health NYU Langone Medical Center, New York, NY 10016, USA.
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9
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Woo M, Lowe SC, Devane AM, Gimbel RW. Intervention to Reduce Interobserver Variability in Computed Tomographic Measurement of Cancer Lesions Among Experienced Radiologists. Curr Probl Diagn Radiol 2020; 50:321-327. [PMID: 32014355 DOI: 10.1067/j.cpradiol.2020.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/01/2020] [Accepted: 01/06/2020] [Indexed: 11/22/2022]
Abstract
While a growing number of research studies have reported the inter-observer variability in computed tomographic (CT) measurements, there are very few interventional studies performed. We aimed to assess whether a peer benchmarking intervention tool may have an influence on reducing interobserver variability in CT measurements and identify possible barriers to the intervention. In this retrospective study, 13 board-certified radiologists repeatedly reviewed 10 CT image sets of lung lesions and hepatic metastases during 3 noncontiguous time periods (T1, T2, T3). Each preselected case contained normal anatomy cephalad and caudal to the lesion of interest. Lesion size measurement under RECISTS 1.1 guidelines, choice of CT slice, and time spent on measurement were captured. Prior to their final measurements, the participants were exposed to the intervention designed to reduce the number of measurements deviating from the median. Chi-square test was performed to identify radiologist-dependent factors associated with the variability. The percent of deviating measurements during T1 and T2 were 20.0% and 23.1%, respectively. There was no statistically significant change in the number of deviating measurements upon the presentation of the intervention despite the decrease in percent from 23.1% to 17.7%. The identified barriers to the intervention include clinical disagreements among radiologists. Specifically, the inter-observer variability was associated with the controversy over the choice of CT image slice (P = 0.045) and selection of start-point, axis, and end-point (P = 0.011). Clinical disagreements rather than random errors were barriers to reducing interobserver variability in CT measurement among experienced radiologists. Future interventions could aim to resolve the disagreement in an interactive approach.
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Affiliation(s)
- MinJae Woo
- Department of Public Health Sciences, Clemson University, SC
| | | | | | - Ronald W Gimbel
- Department of Public Health Sciences, Clemson University, SC.
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Hufnagl C, Leisch M, Weiss L, Melchardt T, Moik M, Asslaber D, Roland G, Steininger P, Meissnitzer T, Neureiter D, Greil R, Egle A. Evaluation of circulating cell-free DNA as a molecular monitoring tool in patients with metastatic cancer. Oncol Lett 2019; 19:1551-1558. [PMID: 31966080 DOI: 10.3892/ol.2019.11192] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 08/06/2019] [Indexed: 01/16/2023] Open
Abstract
The clinical decisions made when treating patients with metastatic cancer require knowledge of the current tumor extent and response to therapy. For the majority of solid tumors, a response assessment, which is based on imaging, is used to guide these decisions. However, measuring serum protein biomarkers (i.e. tumor markers) may be of additional use. Furthermore, tumor markers exhibit variable specificity and sensitivity and cannot therefore be solely relied upon when making decisions regarding cancer treatment. Therefore, there is a clinical requirement for the identification of specific, sensitive and quantitative biomarkers. In recent years, circulating cell-free DNA (cfDNA) and mutation-specific circulating cell-free tumor DNA (cftDNA) have been identified as novel potential biomarkers. In the current study, cfDNA and cftDNA were compared using imaging-based staging and current tumor markers in 15 patients with metastatic colorectal, pancreatic or breast cancer. These patients were treated at the Third Medical Department of Paracelsus Medical University Salzburg (Austria). The results of the current study demonstrated a statistically significant correlation between the concentration changes of cfDNA and cftDNA and response to treatment, which was assessed by imaging. A correlation was not indicated with current clinically used tumor markers, including carcinoembryonic antigen, carcinoma antigen 15-3 and carcinoma antigen 19-9. The present study also indicated a correlation between cfDNA and cftDNA and the tumor volume of metastatic lesions, which was not observed with the current clinically used tumor markers. In conclusion, cfDNA and cftDNA exhibit the potential to become novel biomarkers for the response assessment following cancer treatment, and may serve as a tool for the estimation of tumor volume. The current study further supports the increasingly important role of cfDNA and cftDNA as new monitoring tools for use during cancer therapy.
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Affiliation(s)
- Clemens Hufnagl
- Institute of Pathology, Paracelsus Medical University Salzburg, A-5020 Salzburg, Austria
| | - Michael Leisch
- IIIrd Medical Department with Hematology and Medical Oncology, Oncologic Center, Paracelsus Medical University Salzburg, A-5020 Salzburg, Austria.,Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, A-5020 Salzburg, Austria.,Cancer Cluster Salzburg, A-5020 Salzburg, Austria
| | - Lukas Weiss
- IIIrd Medical Department with Hematology and Medical Oncology, Oncologic Center, Paracelsus Medical University Salzburg, A-5020 Salzburg, Austria.,Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, A-5020 Salzburg, Austria.,Cancer Cluster Salzburg, A-5020 Salzburg, Austria
| | - Thomas Melchardt
- IIIrd Medical Department with Hematology and Medical Oncology, Oncologic Center, Paracelsus Medical University Salzburg, A-5020 Salzburg, Austria.,Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, A-5020 Salzburg, Austria.,Cancer Cluster Salzburg, A-5020 Salzburg, Austria
| | - Martin Moik
- IIIrd Medical Department with Hematology and Medical Oncology, Oncologic Center, Paracelsus Medical University Salzburg, A-5020 Salzburg, Austria.,Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, A-5020 Salzburg, Austria.,Cancer Cluster Salzburg, A-5020 Salzburg, Austria
| | - Daniela Asslaber
- IIIrd Medical Department with Hematology and Medical Oncology, Oncologic Center, Paracelsus Medical University Salzburg, A-5020 Salzburg, Austria.,Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, A-5020 Salzburg, Austria.,Cancer Cluster Salzburg, A-5020 Salzburg, Austria
| | - Geisberger Roland
- IIIrd Medical Department with Hematology and Medical Oncology, Oncologic Center, Paracelsus Medical University Salzburg, A-5020 Salzburg, Austria.,Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, A-5020 Salzburg, Austria.,Cancer Cluster Salzburg, A-5020 Salzburg, Austria
| | - Philipp Steininger
- Institute for Research and Development on Advanced Radiation Technologies, Paracelsus Medical University Salzburg, A-5020 Salzburg, Austria
| | - Thomas Meissnitzer
- Institute of Radiology, Paracelsus Medical University Salzburg, A-5020 Salzburg, Austria
| | - Daniel Neureiter
- Institute of Pathology, Paracelsus Medical University Salzburg, A-5020 Salzburg, Austria
| | - Richard Greil
- IIIrd Medical Department with Hematology and Medical Oncology, Oncologic Center, Paracelsus Medical University Salzburg, A-5020 Salzburg, Austria.,Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, A-5020 Salzburg, Austria.,Cancer Cluster Salzburg, A-5020 Salzburg, Austria
| | - Alexander Egle
- IIIrd Medical Department with Hematology and Medical Oncology, Oncologic Center, Paracelsus Medical University Salzburg, A-5020 Salzburg, Austria.,Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, A-5020 Salzburg, Austria.,Cancer Cluster Salzburg, A-5020 Salzburg, Austria
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11
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Luo Y, Chen J, Shen B, Wang M, Cai H, Xu L, Chen L, Chen M, Li ZP, Feng ST. CT evaluation of response in advanced gastroenteropancreatic neuroendocrine tumors treated with long-acting-repeatable octreotide: what is the optimal size variation threshold? Eur Radiol 2018; 28:5250-5257. [PMID: 29876704 DOI: 10.1007/s00330-018-5512-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 04/16/2018] [Accepted: 04/23/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To identify a reliable early indicator of deriving progression-free survival (PFS) benefit in patients with advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs) treated with octreotide long-acting repeatable (LAR). METHODS We investigated the images of 50 patients with well-differentiated advanced GEP-NETs treated with LAR octreotide and underwent baseline and follow-up thoracic, abdominal, and pelvic computed tomography. Receiver-operating characteristic (ROC) analysis and the Kaplan-Meier method were used to identify the optimal threshold to distinguish between those with and without significant improvement of PFS. RESULTS The optimal threshold for determining a response to octreotide LAR was -10% ΔSLD, with a sensitivity and specificity of 85.7% and 80%, respectively. At this threshold, 19 patients were responders and 31 were non-responders; the median PFS was 20.2 and 7.6 months in responders and non-responders (hazard ratio, 2.66; 95% confidence interval, 1.32-5.36). CONCLUSION A 10% shrinkage in tumor size is an optimal early predictor of response to octreotide LAR in advanced GEP-NETs. KEY POINTS • Octreotide LAR can significantly prolong PFS among patients with well-differentiated advanced GEP-NETs. • No optimal tumor size-based response criteria are reported in GEP-NETs with octreotide. • Ten percent tumor shrinkage is a reliable indicator of the response to octreotide for advanced GEP-NETs.
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Affiliation(s)
- Yanji Luo
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Jie Chen
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Bingqi Shen
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Meng Wang
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Huasong Cai
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Ling Xu
- Faculty of Medicine and Dentistry, University of Western Australia, Perth, 6009, Australia
| | - Luohai Chen
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Minhu Chen
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Zi-Ping Li
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, 510080, Guangdong, China.
| | - Shi-Ting Feng
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, 510080, Guangdong, China.
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12
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Grünwald V, Dietrich M, Pond GR. Early tumor shrinkage is independently associated with improved overall survival among patients with metastatic renal cell carcinoma: a validation study using the COMPARZ cohort. World J Urol 2018; 36:1423-1429. [DOI: 10.1007/s00345-018-2297-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/09/2018] [Indexed: 12/29/2022] Open
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13
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Comparison of the RECIST 1.0 and RECIST 1.1 in patients treated with targeted agents: a pooled analysis and review. Oncotarget 2017; 7:13680-7. [PMID: 26885610 PMCID: PMC4924670 DOI: 10.18632/oncotarget.7322] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/29/2016] [Indexed: 11/25/2022] Open
Abstract
Patients treated with targeted agents were not included in the data warehouse when the RECIST 1.1 was revised in 2009. We conducted this pooled analysis to investigate the impact of the RECIST 1.1 on the assessment of tumor response in cancer patients treated with targeted agents. We surveyed MEDLINE, EMBASE and PubMed for articles with terms of the RECIST 1.0 or RECIST 1.1. We searched for all the references of relevant articles and reviews using the ‘related articles’ feature in the PubMed. There were six articles in the literature comparing the clinical impacts of the RECIST 1.0 and RECIST 1.1 in patients treated with targeted agents for advanced or metastatic cancer. A total of 322 patients were recruited from the six trials; 217 with non-small cell lung cancer, 23 with thyroid cancer, 20 with gastrointestinal stromal tumor, and 62 with renal cell carcinoma. Because of new lymph node criteria, eight patients (2.5%) had no target lesions when adopting the RECIST 1.1. The number of target lesions by the RECIST 1.1 was significantly lower than that by the RECIST 1.0 (P < 0.001). However, the RECIST 1.1 showed high concordance with the RECIST 1.0 in the assessment of best tumor responses (k = 0.908). Seventeen patients (5.6%) showed discrepancy in the best tumor response between the RECIST 1.0 and RECIST 1.1. This pooled study demonstrates that the RECIST 1.1 shows the highly concordant response assessment with the RECIST 1.0 in patients treated with targeted agents.
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Smith AD, Zhang X, Bryan J, Souza F, Roda M, Sirous R, Zhang H, Vasanji A, Griswold M. Vascular Tumor Burden as a New Quantitative CT Biomarker for Predicting Metastatic RCC Response to Antiangiogenic Therapy. Radiology 2016; 281:484-498. [DOI: 10.1148/radiol.2016160143] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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15
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Kok VC, Kuo JT. Pazopanib as a second-line treatment for non-cytokine-treated metastatic renal cell carcinoma: a meta-analysis of the effect of treatment. BMC Urol 2016; 16:34. [PMID: 27377922 PMCID: PMC4932732 DOI: 10.1186/s12894-016-0156-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 06/16/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The currently recommended treatment algorithm for patients with advanced renal cell carcinoma who fail the first-line targeted therapy does not normally include pazopanib as a second-line treatment option. It would therefore be of interest to determine the efficiency of pazopanib in this setting in terms of the partial response rate (PRR), disease control rate (DCR), and progression-free survival (PFS). METHODS Peer-reviewed clinical reports without language restriction, both full papers and conference abstracts, which assessed the second-line use of pazopanib following failure of first-line non-cytokine-targeted therapy, were included. After the literature retrieval, we conducted a Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA)-compliant systematic review of the literature and meta-analysis of the size of the effect of each outcome measure (PRR, DCR, and PFS). The effect size and 95 % confidence interval (CI) were calculated using fixed-effect or random-effects models based on the heterogeneity represented by I(2) of selected studies. Meta-analysis forest plots with a fixed-effect model showing the PRR and DCR were created. RESULTS Our results show that there are no available comparative studies on pazopanib second-line treatment. Only phase II trials or retrospective analysis reports were retrievable. Six studies (comprising 217 patients) were included in the qualitative and quantitative analysis. Pazopanib as a second-line treatment resulted in a PRR of 23 % (95 % CI, 17-31 %; I(2) = 52.6 %) and a DCR of 73 % (95 % CI, 65-80 %; I(2) = 0.00 %). The meta-analysis with fixed-effect model revealed that PFS was 6.5 months (95 % CI, 5.6-7.5 months; I(2) = 86.2 %). CONCLUSIONS In conclusion, the effectiveness and indication of pazopanib for use in the second-line setting has not yet been examined in-depth; however, this meta-analysis has shown that the treatment effects in terms of PRR, DCR, and PFS may be similar to other well-studied second-line targeted therapies. Rigorous comparative phase III trials testing this hypothesis are required.
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Affiliation(s)
- Victor C Kok
- Division of Medical Oncology, Cancer Center of Kuang Tien General Hospital, 117 Shatien Rd, Taichung, 43303, Taiwan.
- Department of Biomedical Informatics, Asia University, Taichung, 41354, Taiwan.
| | - Jung-Tsung Kuo
- Division of Biostatistics, Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, 11221, Taiwan
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16
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Sirous R, Henegan JC, Zhang X, Howard CM, Souza F, Smith AD. Metastatic renal cell carcinoma imaging evaluation in the era of anti-angiogenic therapies. Abdom Radiol (NY) 2016; 41:1086-99. [PMID: 27193601 DOI: 10.1007/s00261-016-0742-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
During the last decade, the arsenal of anti-angiogenic (AAG) agents used to treat metastatic renal cell carcinoma (RCC) has grown and revolutionized the treatment of metastatic RCC, leading to improved overall survival compared to conventional chemotherapy and traditional immunotherapy agents. AAG agents include inhibitors of vascular endothelial growth factor receptor signaling pathways and mammalian target of rapamycin inhibitors. Both of these classes of targeted agents are considered cytostatic rather than cytotoxic, inducing tumor stabilization rather than marked tumor shrinkage. As a result, decreases in tumor size alone are often minimal and/or occur late in the course of successful AAG therapy, while tumor devascularization is a distinct feature of AAG therapy. In successful AAG therapy, tumor devascularization manifests on computed tomography images as a composite of a decrease in tumor size, a decrease in tumor attenuation, and the development of tumor necrosis. In this article, we review Response Evaluation Criteria in Solid Tumors (RECIST)-the current standard of care for tumor treatment response assessment which is based merely on changes in tumor length-and its assessment of metastatic RCC tumor response in the era of AAG therapies. We then review the features of an ideal tumor imaging biomarker for predicting metastatic RCC response to a particular AAG agent and serving as a longitudinal tumor response assessment tool. Finally, a discussion of the more recently proposed imaging response criteria and new imaging trends in metastatic RCC response assessment will be reviewed.
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Affiliation(s)
- Reza Sirous
- Department of Radiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - John C Henegan
- Department of Hematology/Oncology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Xu Zhang
- Center for Biostatistics and Bioinformatics, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Candace M Howard
- Department of Radiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Frederico Souza
- Department of Radiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Andrew D Smith
- Department of Radiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
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