Neoadjuvant therapy is an old idea, with the primary intent to downstage a tumor and increase the likelihood of successful surgical resection. We are using it to extract biomarker information on efficacy of treatment instead, said W. Kimryn Rathmell, M. D., Ph.D., of the Division of Hematology/Oncology at the Lineberger Comprehensive Cancer Center.
In this study, researchers measured patients tumor responses to a short course of treatment before surgery using CT imaging, and analyzed potential biomarkers using functional imaging with PET imaging, blood and urine analysis before and after treatment, and the regulation of genes and proteins within the tumor.
Their first results, evaluating 4 to 8 weeks of sorafenib in 30 patients prior to surgery is currently under analysis. Early results show that among 10 of the 30 patients, the average response is a 10 percent reduction in size of the primary tumor, with a range between 0.8 percent and 28 percent. No tumor progression has been observed in any of the patients, and no unexpected surgical complications have been observed, Dr. Rathmell says.
Treating advanced renal cell carcinoma is difficult because results from clinical trials of new agents in advanced disease are difficult to interpret due to lack of good biomarkers, Dr. Rathmell says. This is because there is limited access to tumor tissue acquired at or around the time of the treatment, the influence of prior therapy received by patients, and the relative co-morbidities these patients have compared to newly diagnosed patient, she said.
Additionally, no genetically engineered mouse models have been validated for renal cell carcinoma, Dr. Rathmell says. Conventional xenograft studies, growing human tumor cells i
|Contact: Greg Lester|
American Association for Cancer Research