Mp10-07 Comprehensive Evaluation of Response to Immune Checkpoint Blockade in Primary Tumor: Radiographic and Radiomic Features Predict Pathologic Response in Primary Tumor

You have accessJournal of UrologyKidney Cancer: Advanced (including Drug Therapy) I (MP10)1 May 2024MP10-07 COMPREHENSIVE EVALUATION OF RESPONSE TO IMMUNE CHECKPOINT BLOCKADE IN PRIMARY TUMOR: RADIOGRAPHIC AND RADIOMIC FEATURES PREDICT PATHOLOGIC RESPONSE IN PRIMARY TUMOR Stephen Reese, Burcin Agridag Ucpinar, Kelly Fitzgerald, Andrea Knezevic, Lennert Eismann, Mark S. Dawidek, Robert Motzer, Martin Voss, Johnathan Coleman, Paul Russo, Yousef Mazaheri Tehrani, Yingbei Chen, Ritesh R. Kotecha, Oguz Akin, and A. Ari Hakimi Stephen ReeseStephen Reese , Burcin Agridag UcpinarBurcin Agridag Ucpinar , Kelly FitzgeraldKelly Fitzgerald , Andrea KnezevicAndrea Knezevic , Lennert EismannLennert Eismann , Mark S. DawidekMark S. Dawidek , Robert MotzerRobert Motzer , Martin VossMartin Voss , Johnathan ColemanJohnathan Coleman , Paul RussoPaul Russo , Yousef Mazaheri TehraniYousef Mazaheri Tehrani , Yingbei ChenYingbei Chen , Ritesh R. KotechaRitesh R. Kotecha , Oguz AkinOguz Akin , and A. Ari HakimiA. Ari Hakimi View All Author Informationhttps://doi.org/10.1097/01.JU.0001008588.39303.c9.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Immune checkpoint blockade (ICB) alone and in combination has dramatically improved outcomes in metastatic renal cell carcinoma (RCC), however there is currently a paucity of biomarkers to predict response to ICB. METHODS: We identified 185 patients who received systemic immune checkpoint blockade (IO/IO or IO/TKI) from 2015 to 2022 with a diagnosis of renal cell carcinoma. Of the 185 patients, 62 patients had the primary kidney tumor present. In sub-groups of patients with the primary tumor present, we recorded radiographic information, including time of initial treatment through treatment failure and receipt of second-line therapy or surgical intervention, the radiographic kinetics of response to therapy, RECIST measurements and 145 radiomic features. In addition we performed a landmark analysis at 3 months and evaluated how this prognosticated a patients clinical outcomes (time to next treatment, OS). Pathologic data was reviewed and recorded. RESULTS: Response to ICB therapy differs across patients with four possible outcomes in met/primary pairs. Response at 3 months to the metastatic and primary lesion prognosticated time-to-next therapy and overall survival, with shrinkage in primary and metastatic disease demonstrating best clinical outcomes and progression in primary and metastatic disease prognosticated the worst outcomes. In addition, depth of response in primary tumor correlates with time-to-next therapy and overall survival (<75% at 3 months associated with best outcomes). Both outcomes were noted to be highly significant (p<0.01). Agreement of radiographic tumor volume and pathologic viable tumor volume (intraclass correlation coefficient 0.20). Pre-operative radiographic tumor volume overestimates pathologic tumor volume for most patients with overall mean difference in volume of 622 cm3 (95% confidence level of mean difference: 285, 958). Pathologic viable tumor volume is positively associated with pre-operative contrast enhancement and change in contrast enhancement (Spearman correlation coefficient ρ=0.41, p=0.02). When examining radiographic features of response to systemic therapy, we noted four 1st and 2nd order radiomic features that identified patients with minimal residual disease on pathologic evaluation. CONCLUSIONS: Herein we provide a comprehensive clinical, radiographic and pathologic evaluation of patients with metastatic renal cell carcinoma with primary tumor intact. Further analyses like this can help estimate clinical and pathologic tumor response at time of surgery and can be helpful in making non-invasive determinations about prognosis and/or response to therapy. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e140 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Stephen Reese More articles by this author Burcin Agridag Ucpinar More articles by this author Kelly Fitzgerald More articles by this author Andrea Knezevic More articles by this author Lennert Eismann More articles by this author Mark S. Dawidek More articles by this author Robert Motzer More articles by this author Martin Voss More articles by this author Johnathan Coleman More articles by this author Paul Russo More articles by this author Yousef Mazaheri Tehrani More articles by this author Yingbei Chen More articles by this author Ritesh R. Kotecha More articles by this author Oguz Akin More articles by this author A. Ari Hakimi More articles by this author Expand All Advertisement PDF downloadLoading ...