Discrepancy between reported progressive disease per radiology report and treating oncologist tumor measurements in patients with metastatic renal cell carcinoma (mRCC) receiving sunitinib.
Year: 2012
Type: conference-abstract
Abstract: 420 Background: The determination of progressive disease (PD) on sunitinib in mRCC by conventional tumor size criteria is often complex. Frequently, radiology reports cite disease progression that does not meet RECIST criteria or does not adequately describe index lesions. Characterization of the frequency and magnitude of this phenomenon has not been previously reported. Methods: The medical records of a subset of mRCC patients treated at The Cleveland Clinic who had received sunitinib for > 12 months were retrospectively reviewed. All Radiology reports from post-baseline scans were reviewed for the presence of text in the body or conclusion of the report consistent with disease progression (specifically the terms ‘progressive’, ‘new’ and/or ‘interval enlargement/worsening’). The date of the report first containing one or more of these terms was recorded, as was the date of RECIST-defined PD determined by the treating Oncologist. Results: Twenty patients were identified in an initial review. Patient characteristics included: 85% male, 100% clear cell histology, 90% prior nephrectomy and 80% with prior systemic therapy. Thirteen patients (65%) had a radiology report citing a progressive disease term prior to treating physician-determined RECIST-defined PD. The median time from first radiology report citing a progressive disease term until RECIST PD per Oncologist measurements was 2.9 months (range, 0 to 12.8 months). Conclusions: There is significant discrepancy between the first mention of disease progression by a Radiology report and when a treating Oncologist measures disease progression per RECIST criteria. This discrepancy could impact patient care by influencing drug discontinuation. These data emphasize the importance of multidisciplinary scan review and tumor measurements by both radiologists and treating physicians. Analysis is ongoing in additional patients.
Source: Journal of Clinical Oncology
Institution: Cleveland Clinic
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W2585585422