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Combined Metabolically Active Tumor Volume and Early Metabolic Response Improve Outcome Prediction in Metastatic Colorectal Cancer
- Source :
- The Journal of nuclear medicine, 63 (4
- Publication Year :
- 2022
-
Abstract
- Stratification of metastatic colorectal cancer (mCRC) patients is mostly based on clinical and biologic characteristics. This study aimed to validate the prognostic value of 18F-FDG PET/CT–based biomarkers such as baseline whole-body metabolically active tumor volume (WB-MATV) and early metabolic response (mR) in mCRC. Methods: The development cohort included chemorefractory mCRC patients enrolled in 2 prospective Belgian multicenter trials evaluating last-line treatments (multikinase inhibitors). The validation cohort included mCRC patients from an Italian center treated with chemotherapy and bevacizumab as first-line. Baseline WB-MATV was defined as the sum of metabolically active volumes of all target lesions identified on the baseline 18F-FDG PET/CT. Early mR assessment was performed following usual response criteria (response threshold of 30% [PERCIST–30%], response threshold of 15% [PERCIST–15%], European Organization for Research and Treatment of Cancer) and the so-called CONSIST method, which defines response as a decrease of SULmax $ 15% for all target lesions. Baseline WB-MATV and early mR assessment were investigated along with usual clinical factors and correlated with overall survival (OS) and progression-free survival (PFS). Results: Clinical factors, baseline WB-MATV, and early mR were evaluable in 192 of 239 and 94 of 125 patients of the development and validation cohorts, respectively. Except for PERCIST–30%, all response methods were equivalent in terms of outcome prediction, and CONSIST was found to be the most accurate. Baseline WB-MATV and early mR using the CONSIST method were independent prognostic parameters after adjustment for clinical factors in the development and validation sets for both OS (hazard ratio [HR] WB-MATV: 1.87 [95% CI, 1.17–2.97], P 5 0.005, and HR early mR: 1.79 [95% CI, 1.08–2.95], P 5 0.02 for the validation set) and PFS (HR WB-MATV: 1.94 [95% CI, 1.27–2.97], P 5 0.002, and HR early mR: 1.69 [95% CI, 1.04–2.73], P 5 0.03<br />SCOPUS: ar.j<br />info:eu-repo/semantics/published
Details
- Database :
- OAIster
- Journal :
- The Journal of nuclear medicine, 63 (4
- Notes :
- 2 full-text file(s): application/pdf | application/pdf, English
- Publication Type :
- Electronic Resource
- Accession number :
- edsoai.on1335124119
- Document Type :
- Electronic Resource