Comparison of tumor response assessment methods in patients with metastatic colorectal cancer after locoregional therapy

Akinwande, Olaguoke; Philips, Prejesh; Scoggins, Charles R.; Kelly, Lawrence R.; Tatum, Cliff; Hahl, Mike; McMasters, Kelly M.; Martin, Robert C.G.

doi:10.1002/jso.24141

Cited by 15 publications

(8 citation statements)

References 16 publications

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“…Several methods for evaluating radiological response following transarterial treatment of liver tumors have been developed, where overall the Response Evaluation Criteria in Solid Tumors (RECIST) is the most used (174)(175)(176)(177)(178). For HCC treatment the recommended systems are RECIST and the modified version of RECIST (mRECIST), with the latter being the preferred system (41).…”

Section: Radiological Response After Dee-tacementioning

confidence: 99%

“…It is well described that the residual arterial contrast enhancement after TACE is an important prognostic tool in HCC (41,177,191), for which mRECIST has been developed (179), Figure 9. However while mRECIST is the preferred radiological response system in HCC (41), this is more controversial in metastatic disease (174). In study 2 most patients had progressive disease due to new lesions, and therefore would have been categorized as progressive disease also if mRECIST (table 3) had been used.…”

Section: Figure 8 Image From 3d Volume Rendering Of Cone Beam Ct Obtmentioning

confidence: 99%

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ALBI and P-ALBI grade in Child-Pugh A patients treated with drug eluting embolic chemoembolization for hepatocellular carcinoma

et al. 2018

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Background Treatment outcome for hepatocellular carcinoma (HCC) is related to tumor burden and liver function. Grading systems assessing liver function need validation in different clinical settings. Purpose To evaluate drug-eluting embolic transarterial chemoembolization (DEE-TACE) in Child-Pugh A HCC with respect to albumin-bilirubin (ALBI) and platelet-albumin-bilirubin (P-ALBI) grade. Material and Methods Forty-nine patients with Child-Pugh class A, diagnosed with HCC and allocated to DEE-TACE treatment, were retrospectively analyzed regarding tumor and treatment characteristics, radiological response (mRECIST) one month post treatment, overall survival (OS), and adverse events (AEs; CTCAE, grades ≥3) with respect to ALBI and P-ALBI grade. Results There were 21 ALBI 1 patients, 29 P-ALBI 1 patients, and 19 patients were both ALBI and P-ALBI 1. Objective response rate was 74% with no statistically significant difference for ALBI (1 vs. 2; P = 0.08), or P-ALBI (1 vs. 2; P = 0.49). OS was 14.8 months (range = 1.7-62.0; ALBI 1 vs. 2: P = 0.08; P-ALBI 1 vs. 2: P = 0.003). OS in responders with ALBI 1 and 2 was 28.9 vs.10.2 months ( P = 0.02), and P-ALBI 1 and 2 was 26.7 vs. 8.6 months ( P < 0.001). In multivariate analyses, both ALBI 2 (HR = 2.4, P = 0.02) and P-ALBI 2 (HR = 3.3, P < 0.01) were negative prognostic factors for survival. There were 15 AEs in 13 patients, with hepatic failure only occurring in ALBI 2 and P-ALBI 2 patients. Conclusion P-ALBI grade 1 and 2 differentiated survival in Child-Pugh A patients treated with DEE-TACE. Both grading systems can differentiate survival in patients responding to treatment.

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Section: Radiological Response After Dee-tacementioning

confidence: 99%

Section: Figure 8 Image From 3d Volume Rendering Of Cone Beam Ct Obtmentioning

confidence: 99%

ALBI and P-ALBI grade in Child-Pugh A patients treated with drug eluting embolic chemoembolization for hepatocellular carcinoma

et al. 2018

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“… 25 However, response was evaluated using the modified RECIST criteria, which are not adequate for DEBIRI in mCRC. 26 When considering RECIST 1.1 criteria, this study found a response rate of 97% with DEBIRI + FOLFOX, but, more surprisingly, also 95% in patients treated with FOLFOX alone, a value far from those generally reported with this regimen.…”

Section: Discussionmentioning

confidence: 68%

Intra-arterial hepatic beads loaded with irinotecan (DEBIRI) with mFOLFOX6 in unresectable liver metastases from colorectal cancer: a Phase 2 study

et al. 2020

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Background Chemo-embolisation with drug-eluting beads loaded with irinotecan (DEBIRI) increased survival as compared with intravenous irinotecan in chemorefractory patients with liver-dominant metastases from colorectal cancer (LMCRC). First-line DEBIRI with systemic chemotherapy may increase survival and secondary resection. Methods In the FFCD-1201 single-arm Phase 2 study, patients with untreated, non-resectable LMCRC received DEBIRI plus mFOLFOX6. Four courses of DEBIRI were performed alternating right and left lobe or two sessions with both lobes treated during the same session. Results Fifty-seven patients were enrolled. Grade 3–5 toxicities were more frequent when both lobes were treated during the same session (90.5% versus 52.8%). Nine-month PFS rate was 53.6% (95% CI, 41.8–65.1%). The objective response rate (RECIST 1.1) was 73.2%, and the secondary R0 surgery was 33%. With a median follow-up of 38.3 months, median OS was 37.4 months (95% CI, 25.7–45.8), and median PFS 10.8 months (95% CI, 8.2–12.3). Conclusions Front-line DEBIRI + mFOLFOX6 should not be recommended as the hypothesised 9-month PFS was not met. However, high response rate, deep responses, and prolonged OS encourage further evaluation in strategies integrating biologic agent, in particular in patients with secondary surgery as the main goal. Clinical trial registration NCT01839877.

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“…Partial response suggests a better prognosis, while stable disease is likely due to tumor cell resistance. However, recent findings question the effectiveness of RECIST in colorectal cancer patients [ 19 ]. The conventional tumor size-based radiologic criteria of RECIST may be inadequate in assessing response to chemotherapy, especially in patients treated with a regimen including bevacizumab [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Long-term postoperative survival prediction in patients with colorectal liver metastasis

et al. 2017

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Numerous factors affect the prognosis of colorectal liver metastasis (CRLM) patients after hepatic resection. We investigated several factors related to overall survival in patients with CRLM to identify those most likely to benefit from hepatic resection, and produced a rational tumor biology score system. Three hundred CRLM patients treated with preoperative chemotherapy followed by hepatic resection between 2006 and 2016 were enrolled in our study. Clinicopathologic and long-term survival data were collected and assessed. Patient 1-, 3-, and 5-year overall survival rates were 92.7%, 58.3%, and 45.8%, respectively, while 1-, 3-, and 5-year disease-free survival rates were 44.7%, 28.6%, and 24.2%, respectively. Multivariate Cox regression analysis revealed poor preoperative chemotherapy response, Fong clinical risk score > 2, and KRAS mutation to be independent prognostic indicators in CRLM patients. As part of a preoperative staging system in which one point was assigned for each factor, a total score (out of 3) was predictive of long-term survival following surgery. These factors facilitate personalized prognostic assessments in CRLM patients planning for resection.

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Comparison of tumor response assessment methods in patients with metastatic colorectal cancer after locoregional therapy

Cited by 15 publications

References 16 publications

ALBI and P-ALBI grade in Child-Pugh A patients treated with drug eluting embolic chemoembolization for hepatocellular carcinoma

ALBI and P-ALBI grade in Child-Pugh A patients treated with drug eluting embolic chemoembolization for hepatocellular carcinoma

Intra-arterial hepatic beads loaded with irinotecan (DEBIRI) with mFOLFOX6 in unresectable liver metastases from colorectal cancer: a Phase 2 study

Long-term postoperative survival prediction in patients with colorectal liver metastasis

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