scholarly journals Case Report: Early 68Ga-PSMA-PET Metabolic Assessment and Response to Systemic Treatment for First-Line Metastatic Clear Cell Renal Cell Carcinoma; About Two Clinical Cases

2021 ◽  
Vol 11 ◽  
Author(s):  
Emmanuel Seront ◽  
Renaud Lhommel ◽  
Bertrand Tombal

Early evaluation of response to anticancer treatment in metastatic renal cell carcinoma (RCC) is challenging as responses are sometimes delayed, as mixed responses can occur, and as conventional imaging have some limitations. As PSMA has been previously identified in neovasculature of clear cell RCC (ccRCC), 68Ga-PSMA-Positron Emitted Tomography (PET) could appear as an interesting tool to evaluate therapeutic response. We describe the association of an early decrease in 68Ga metabolism (at 8 weeks after treatment onset) and further radiological response (at 12 weeks after treatment onset) to treatment in two patients with different sensitivity to axitinib–pembrolizumab combination. Interestingly, one of these patients presented an initial progressive disease on pembrolizumab alone and a subsequent response to axitinib alone in the disease course; these response profiles were associated with absence of decrease and subsequent decrease in the 68Ga metabolism, respectively. Even if further prospective trials are needed, 68Ga-PSMA-PET may appear as a promising way for early prediction of response to ccRCC systemic treatment.

2016 ◽  
Vol 195 (4S) ◽  
Author(s):  
Handoo Rhee ◽  
Chui Ming Tham ◽  
Paul Thomas ◽  
John Blazak ◽  
Hema Samaratunga ◽  
...  

2019 ◽  
Vol 75 (1) ◽  
pp. 100-110 ◽  
Author(s):  
Aly-Khan A. Lalani ◽  
Bradley A. McGregor ◽  
Laurence Albiges ◽  
Toni K. Choueiri ◽  
Robert Motzer ◽  
...  

2014 ◽  
Vol 41 (7) ◽  
pp. 1461-1462 ◽  
Author(s):  
Emre Demirci ◽  
Meltem Ocak ◽  
Levent Kabasakal ◽  
Clemens Decristoforo ◽  
Zübeyir Talat ◽  
...  

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1142
Author(s):  
Falk Gühne ◽  
Philipp Seifert ◽  
Bernhard Theis ◽  
Matthias Steinert ◽  
Martin Freesmeyer ◽  
...  

PET/CT with prostate-specific membrane antigen (PSMA)-targeted tracers has been used in the diagnosis and staging of patients with clear cell renal cell carcinoma (ccRCC). For ccRCC primary tumors, PET parameters were shown to predict histologic grade and features. The aim of this study was to correlate PSMA PET/CT with histopathological findings in patients with metastatic recurrence of ccRCC. Patients with ccRCC who underwent PSMA-targeted PET/CT and subsequent histopathological evaluation of suspicious lesions were included. Specimens underwent immunohistochemical marking. Lesion diameter, volume and tracer uptake were correlated with the extent and intensity of molecular PSMA expression and with clinical findings. Twelve PET-positive lesions of nine patients were evaluated. Eleven ccRCC metastases and one prostate carcinoma were detected histopathologically. Molecular PSMA expression was detected in all lesions, which intensity and distribution did not correlate with PET parameters. PSMA-targeted PET/CT is a feasible tool for the evaluation of patients with ccRCC but cannot reliably predict histologic features of metastases. PSMA may also be expressed in malignant lesions other than ccRCC, leading to incidental detection of these tumors.


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