Utility of clinical and MR imaging parameters for prediction and monitoring of response to capecitabine and temozolomide (CAPTEM) therapy in patients with liver metastases of neuroendocrine tumors.

CAPTEM therapy MR imaging clinical parameters liver metastases neuroendocrine tumors treatment response

Journal

Radiology and oncology
ISSN: 1581-3207
Titre abrégé: Radiol Oncol
Pays: Poland
ID NLM: 9317213

Informations de publication

Date de publication:
14 Apr 2024
Historique:
received: 08 12 2023
accepted: 20 02 2024
medline: 13 4 2024
pubmed: 13 4 2024
entrez: 13 4 2024
Statut: aheadofprint

Résumé

This study explores the predictive and monitoring capabilities of clinical and multiparametric MR parameters in assessing capecitabine and temozolomide (CAPTEM) therapy response in patients with neuroendocrine tumors (NET). This retrospective study (n = 44) assessed CAPTEM therapy response in neuroendocrine liver metastases (NELM) patients. Among 33 monitored patients, as a subgroup of the overall study cohort, pretherapeutic and follow-up MRI data (size, apparent diffusion coefficient [ADC] values, and signal intensities), along with clinical parameters (chromogranin A [CgA] and Ki-67%), were analyzed. Progression-free survival (PFS) served as the reference. Responders were defined as those with PFS ≥ 6 months. Most patients were male (75%) and had G2 tumors (76%) with a pancreatic origin (84%). Median PFS was 5.7 months; Overall Survival (OS) was 25 months. Non-responders (NR) had higher Ki-67 in primary tumors (16.5 Survival analysis emphasizes the need for adapted response criteria, involving combined evaluation of CgA, ADC values, and tumor size for monitoring CAPTEM response in hepatic metastasized NETs.

Sections du résumé

BACKGROUND BACKGROUND
This study explores the predictive and monitoring capabilities of clinical and multiparametric MR parameters in assessing capecitabine and temozolomide (CAPTEM) therapy response in patients with neuroendocrine tumors (NET).
PATIENTS AND METHODS METHODS
This retrospective study (n = 44) assessed CAPTEM therapy response in neuroendocrine liver metastases (NELM) patients. Among 33 monitored patients, as a subgroup of the overall study cohort, pretherapeutic and follow-up MRI data (size, apparent diffusion coefficient [ADC] values, and signal intensities), along with clinical parameters (chromogranin A [CgA] and Ki-67%), were analyzed. Progression-free survival (PFS) served as the reference. Responders were defined as those with PFS ≥ 6 months.
RESULTS RESULTS
Most patients were male (75%) and had G2 tumors (76%) with a pancreatic origin (84%). Median PFS was 5.7 months; Overall Survival (OS) was 25 months. Non-responders (NR) had higher Ki-67 in primary tumors (16.5
CONCLUSIONS CONCLUSIONS
Survival analysis emphasizes the need for adapted response criteria, involving combined evaluation of CgA, ADC values, and tumor size for monitoring CAPTEM response in hepatic metastasized NETs.

Identifiants

pubmed: 38613843
pii: raon-2024-0024
doi: 10.2478/raon-2024-0024
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 Maria Ingenerf et al., published by Sciendo.

Références

Wang W, Zhang Y, Peng Y, Jin KZ, Li YL, Liang Y, et al. A Ki-67 index to predict treatment response to the capecitabine/temozolomide regimen in neuroendocrine neoplasms: a retrospective multicenter study. Neuroendocrinology 2021; 111: 752–63. doi: 10.1159/000510159
doi: 10.1159/000510159
Dogan I, Tastekin D, Karabulut S, Sakar B. Capecitabine and temozolomide (CAPTEM) is effective in metastatic well-differentiated gastrointestinal neuroendocrine tumors. J Dig Dis 2022; 23: 493–9. doi: 10.1111/1751-2980.13123
doi: 10.1111/1751-2980.13123
Al-Toubah T, Pelle E, Valone T, Haider M, Strosberg JR. Efficacy and toxicity analysis of capecitabine and temozolomide in neuroendocrine neoplasms. J Natl Compr Canc Netw 2021; 20: 29–36. doi: 10.6004/jnccn.2021.7017
doi: 10.6004/jnccn.2021.7017
Strosberg JR, Fine RL, Choi J, Nasir A, Coppola D, Chen DT, et al. First-line chemotherapy with capecitabine and temozolomide in patients with metastatic pancreatic endocrine carcinomas. Cancer 2011; 117: 268–75. doi: 10.1002/cncr.25425
doi: 10.1002/cncr.25425
Ramirez RA, Beyer DT, Chauhan A, Boudreaux JP, Wang YZ, Woltering EA. The role of capecitabine/temozolomide in metastatic neuroendocrine tumors. Oncologist 2016; 21: 671–5. doi: 10.1634/theoncologist.2015-0470
doi: 10.1634/theoncologist.2015-0470
Arrivi G, Verrico M, Roberto M, Barchiesi G, Faggiano A, Marchetti P, et al. Capecitabine and temozolomide (CAPTEM) in advanced neuroendocrine neoplasms (NENs): a systematic review and pooled analysis. Cancer Manag Res 2022; 14: 3507–23. doi: 10.2147/cmar.S372776
doi: 10.2147/cmar.S372776
Cives M, Ghayouri M, Morse B, Brelsford M, Black M, Rizzo A, et al. Analysis of potential response predictors to capecitabine/temozolomide in metastatic pancreatic neuroendocrine tumors. Endocr Relat Cancer 2016; 23: 759–67. doi: 10.1530/erc-16-0147
doi: 10.1530/erc-16-0147
Zhang G, Xu Z, Zheng J, Wang M, Ren J, Wei X, et al. Prognostic value of multi b-value DWI in patients with locally advanced rectal cancer. Eur Radiol 2023; 33: 1928–37. doi: 10.1007/s00330-022-09159-7
doi: 10.1007/s00330-022-09159-7
Ingenerf M, Kiesl S, Winkelmann M, Auernhammer CJ, Rübenthaler J, Grawe F, et al. Treatment assessment of pNET and NELM after everolimus by quantitative MRI parameters. Biomedicines 2022: 10: 2618. doi: 10.3390/biomedicines10102618
doi: 10.3390/biomedicines10102618
Yuan W, Yu Q, Wang Z, Huang J, Wang J, Long L. Efficacy of diffusion-weighted imaging in neoadjuvant chemotherapy for osteosarcoma: a systematic review and meta-analysis. Acad Radiol 2022; 29: 326–34. doi: 10.1016/j.acra.2020.11.013
doi: 10.1016/j.acra.2020.11.013
Luo Y, Pandey A, Ghasabeh MA, Pandey P, Varzaneh FN, et al. Prognostic value of baseline volumetric multiparametric MR imaging in neuroendocrine liver metastases treated with transarterial chemoembolization. Eur Radiol 2019; 29: 5160–71. doi: 10.1007/s00330-019-06100-3
doi: 10.1007/s00330-019-06100-3
Strosberg JR, Cives M, Brelsford M, Black M, Meeker A, Ghayouri M. Identification of response predictors to capecitabine/temozolomide in metastatic pancreatic neuroendocrine tumors. J Clin Oncol 2015; 33: 4099. doi: 10.1200/jco.2015.33.15_suppl.4099
doi: 10.1200/jco.2015.33.15_suppl.4099
Gerson SL. MGMT: its role in cancer aetiology and cancer therapeutics. Nat Rev Cancer 2004; 4: 296–307. doi: 10.1038/nrc1319
doi: 10.1038/nrc1319
14. Baudin E, Bidart JM, Bachelot A, Ducreux M, Elias D, Ruffié P, et al. Impact of chromogranin A measurement in the work-up of neuroendocrine tumors. Annalf Oncol 2001; 12 Suppl 2: S79–82. doi: 10.1093/annonc/12.suppl_2.s79
doi: 10.1093/annonc/12.suppl_2.s79
Yao JC, Pavel M, Phan AT, Kulke MH, Hoosen S, St Peter J, et al. Chromogranin A and neuron-specific enolase as prognostic markers in patients with advanced pNET treated with everolimus. J Clin Endocrinol Metab 2011; 96: 3741–9. doi: 10.1210/jc.2011-0666
doi: 10.1210/jc.2011-0666
Chou WC, Chen JS, Hung YS, Hsu JT, Chen TC, Sun CF, et al. Plasma chromogranin A levels predict survival and tumor response in patients with advanced gastroenteropancreatic neuroendocrine tumors. Anticancer Res 2014; 34: 5661–9.
Chou WC, Hung YS, Hsu JT, Chen JS, Lu CH, Hwang TL, et al. Chromogranin A is a reliable biomarker for gastroenteropancreatic neuroendocrine tumors in an Asian population of patients. Neuroendocrinology 2012; 95: 344–50. doi: 10.1159/000333853
doi: 10.1159/000333853
Tsai H-J, Hsiao C-F, Chang JS, Chen L-T, Chao Y-J, Yen C-J, et al. The Prognostic and predictive role of chromogranin A in gastroenteropancreatic neuroendocrine tumors – a single-center experience. Front Oncol 2021; 11: 741096. doi: 10.3389/fonc.2021.741096
doi: 10.3389/fonc.2021.741096
de Mestier L, Dromain C, d’Assignies G, Scoazec J-Y, Lassau N, Lebtahi R, et al. Evaluating digestive neuroendocrine tumor progression and therapeutic responses in the era of targeted therapies: state of the art. Endocr Relat Cancer 2014; 21: R105–R120. doi: 10.1530/erc-13-0365
doi: 10.1530/erc-13-0365
Lencioni R, Llovet JM. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis 2010; 30: 52–60. doi: 10.1055/s-0030-1247132
doi: 10.1055/s-0030-1247132
Merino-Casabiel X, Aller J, Arbizu J, García-Figueiras R, González C, Grande E, et al. Consensus document on the progression and treatment response criteria in gastroenteropancreatic neuroendocrine tumors. Clin Transl Oncol 2018; 20: 1522–8. doi: 10.1007/s12094-018-1881-9
doi: 10.1007/s12094-018-1881-9
Yao JC, Phan AT, Fogleman D, Ng CS, Jacobs CB, Dagohoy CD, et al. Randomized run-in study of bevacizumab (B) and everolimus (E) in lowto intermediate-grade neuroendocrine tumors (LGNETs) using perfusion CT as functional biomarker. J Clin Oncol 2010; 28: 4002. doi: 10.1200/jco.2010.28.15_suppl.4002
doi: 10.1200/jco.2010.28.15_suppl.4002
Ingenerf MK, Karim H, Fink N, Ilhan H, Ricke J, Treitl KM, et al. Apparent diffusion coefficients (ADC) in response assessment of transarterial radioembolization (TARE) for liver metastases of neuroendocrine tumors (NET): a feasibility study. Acta Radiol 2022; 63: 878–88. doi: 10.1177/02841851211024004
doi: 10.1177/02841851211024004
Min JH, Kang TW, Kim YK, Kim SH, Shin KS, Lee JE, et al. Hepatic neuroendocrine tumour: apparent diffusion coefficient as a potential marker of prognosis associated with tumour grade and overall survival. Eur Radiol 2018; 28: 2561–71. doi: 10.1007/s00330-017-5248-3
doi: 10.1007/s00330-017-5248-3
Vandecaveye V, Dresen RC, Pauwels E, Binnebeek SV, Vanslembrouck R, Baete K, et al. Early whole-body diffusion-weighted MRI helps predict long-term outcome following peptide receptor radionuclide therapy for metastatic neuroendocrine tumors. Radiol Imaging Cancer 2022; 4: e210095. doi: 10.1148/rycan.210095
doi: 10.1148/rycan.210095

Auteurs

Maria Ingenerf (M)

Department of Radiology, University Hospital, LMU Munich, Germany.

Christoph Auernhammer (C)

ENETS Centre of Excellence, Interdisciplinary Center of Neuroendocrine Tumours of the GastroEnteroPancreatic System at the University Hospital of Munich (GEPNET-KUM), University Hospital of Munich, Munich, Germany.
Department of Internal Medicine 4, University Hospital, LMU Munich, Munich, Germany.

Roberto Lorbeer (R)

Department of Radiology, University Hospital, LMU Munich, Germany.

Michael Winkelmann (M)

Department of Radiology, University Hospital, LMU Munich, Germany.

Shiwa Mansournia (S)

Department of Radiology, University Hospital, LMU Munich, Germany.

Nabeel Mansour (N)

Department of Radiology, University Hospital, LMU Munich, Germany.

Nina Hesse (N)

Department of Radiology, University Hospital, LMU Munich, Germany.

Kathrin Heinrich (K)

Department of Medicine III, University Hospital, University of Munich, Munich, Germany.

Jens Ricke (J)

Department of Radiology, University Hospital, LMU Munich, Germany.
ENETS Centre of Excellence, Interdisciplinary Center of Neuroendocrine Tumours of the GastroEnteroPancreatic System at the University Hospital of Munich (GEPNET-KUM), University Hospital of Munich, Munich, Germany.

Frank Berger (F)

Department of Radiology, University Hospital, LMU Munich, Germany.

Christine Schmid-Tannwald (C)

Department of Radiology, University Hospital, LMU Munich, Germany.
ENETS Centre of Excellence, Interdisciplinary Center of Neuroendocrine Tumours of the GastroEnteroPancreatic System at the University Hospital of Munich (GEPNET-KUM), University Hospital of Munich, Munich, Germany.

Classifications MeSH