Standard diametric versus volumetric early tumor shrinkage as a predictor of survival in metastatic colorectal cancer: subgroup findings of the randomized, open-label phase III trial FIRE-3 / AIO KRK-0306.
Humans
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Bevacizumab
/ therapeutic use
Camptothecin
/ therapeutic use
Cetuximab
/ therapeutic use
Colonic Neoplasms
Colorectal Neoplasms
/ pathology
Disease-Free Survival
Fluorouracil
/ therapeutic use
Rectal Neoplasms
Retrospective Studies
Colorectal neoplasms
Multidetector computed tomography
Neoplasm metastasis
ROC curve
Response Evaluation Criteria in Solid Tumors
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
16
05
2022
accepted:
24
07
2022
revised:
16
05
2022
pubmed:
18
8
2022
medline:
3
2
2023
entrez:
17
8
2022
Statut:
ppublish
Résumé
Early tumor shrinkage (ETS) quantifies the objective response at the first assessment during systemic treatment. In metastatic colorectal cancer (mCRC), ETS gains relevance as an early available surrogate for patient survival. The aim of this study was to increase the predictive accuracy of ETS by using semi-automated volumetry instead of standard diametric measurements. Diametric and volumetric ETS were retrospectively calculated in 253 mCRC patients who received 5-fluorouracil, leucovorin, and irinotecan (FOLFIRI) combined with either cetuximab or bevacizumab. The association of diametric and volumetric ETS with overall survival (OS) and progression-free survival (PFS) was compared. Continuous diametric and volumetric ETS predicted survival similarly regarding concordance indices (p > .05). In receiver operating characteristics, a volumetric threshold of 45% optimally identified short-term survivors. For patients with volumetric ETS ≥ 45% (vs < 45%), median OS was longer (32.5 vs 19.0 months, p < .001) and the risk of death reduced for the first and second year (hazard ratio [HR] = 0.25, p < .001, and HR = 0.39, p < .001). Patients with ETS ≥ 45% had a reduced risk of progressive disease only for the first 6 months (HR = 0.26, p < .001). These survival times and risks were comparable to those of diametric ETS ≥ 20% (vs < 20%). The accuracy of ETS in predicting survival was not increased by volumetric instead of diametric measurements. Continuous diametric and volumetric ETS similarly predicted survival, regardless of whether patients received cetuximab or bevacizumab. A volumetric ETS threshold of 45% and a diametric ETS threshold of 20% equally identified short-term survivors. • ETS based on volumetric measurements did not predict survival more accurately than ETS based on standard diametric measurements. • Continuous diametric and volumetric ETS predicted survival similarly in patients receiving FOLFIRI with cetuximab or bevacizumab. • A volumetric ETS threshold of 45% and a diametric ETS threshold of 20% equally identified short-term survivors.
Identifiants
pubmed: 35976398
doi: 10.1007/s00330-022-09053-2
pii: 10.1007/s00330-022-09053-2
pmc: PMC9889429
doi:
Substances chimiques
Bevacizumab
2S9ZZM9Q9V
Camptothecin
XT3Z54Z28A
Cetuximab
PQX0D8J21J
Fluorouracil
U3P01618RT
Types de publication
Clinical Trial, Phase III
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
1174-1184Informations de copyright
© 2022. The Author(s).
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