Transarterial Chemoembolization Alone or Followed by Bevacizumab for Treatment of Colorectal Liver Metastases

Fiorentini, Giammaria; Sarti, Donatella; Nardella, Michele; Inchingolo, Riccardo; Nestola, Massimiliano; Rebonato, Alberto; Fiorentini, Caterina; Aliberti, Camillo; Nani, Roberto; Guadagni, Stefano

doi:10.2217/hep-2020-0031

Cited by 2 publications

(2 citation statements)

References 33 publications

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“…CRC accounts for approximately 10% of all tumors ( 2 ). The liver is the most common metastatic site for CRC, and approximately a quarter of all patients with CRC have liver metastases ( 3 , 4 ). Surgery is the best treatment for colorectal cancer liver metastases (CRLMs).…”

Section: Introductionmentioning

confidence: 99%

Dynamic radiomics for predicting the efficacy of antiangiogenic therapy in colorectal liver metastases

Zhai

Zhang

et al. 2023

Front. Oncol.

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Background and objectiveFor patients with advanced colorectal liver metastases (CRLMs) receiving first-line anti-angiogenic therapy, an accurate, rapid and noninvasive indicator is urgently needed to predict its efficacy. In previous studies, dynamic radiomics predicted more accurately than conventional radiomics. Therefore, it is necessary to establish a dynamic radiomics efficacy prediction model for antiangiogenic therapy to provide more accurate guidance for clinical diagnosis and treatment decisions.MethodsIn this study, we use dynamic radiomics feature extraction method that extracts static features using tomographic images of different sequences of the same patient and then quantifies them into new dynamic features for the prediction of treatmentefficacy. In this retrospective study, we collected 76 patients who were diagnosed with unresectable CRLM between June 2016 and June 2021 in the First Hospital of China Medical University. All patients received standard treatment regimen of bevacizumab combined with chemotherapy in the first-line treatment, and contrast-enhanced abdominal CT (CECT) scans were performed before treatment. Patients with multiple primary lesions as well as missing clinical or imaging information were excluded. Area Under Curve (AUC) and accuracy were used to evaluate model performance. Regions of interest (ROIs) were independently delineated by two radiologists to extract radiomics features. Three machine learning algorithms were used to construct two scores based on the best response and progression-free survival (PFS).ResultsFor the task that predict the best response patients will achieve after treatment, by using ROC curve analysis, it can be seen that the relative change rate (RCR) feature performed best among all features and best in linear discriminantanalysis (AUC: 0.945 and accuracy: 0.855). In terms of predicting PFS, the Kaplan–Meier plots suggested that the score constructed using the RCR features could significantly distinguish patients with good response from those with poor response (Two-sided P<0.0001 for survival analysis).ConclusionsThis study demonstrates that the application of dynamic radiomics features can better predict the efficacy of CRLM patients receiving antiangiogenic therapy compared with conventional radiomics features. It allows patients to have a more accurate assessment of the effect of medical treatment before receiving treatment, and this assessment method is noninvasive, rapid, and less expensive. Dynamic radiomics model provides stronger guidance for the selection of treatment options and precision medicine.

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Section: Introductionmentioning

confidence: 99%

Dynamic radiomics for predicting the efficacy of antiangiogenic therapy in colorectal liver metastases

Zhai

Zhang

et al. 2023

Front. Oncol.

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“…For patients with liver-only or liver-dominant lesions, irinotecan-based transarterial chemoembolization (irinotecan-TACE) has to be considered as part of the toolbox of loco-regional treatment strategies [ 1 ]. It can be used together with systemic treatment or alone [ 8 , 9 , 10 ] and may be used in first or later line therapy. Irinotecan-TACE is generally well tolerated with serious adverse events (AEs) experienced in about 0–10% of patients [ 11 , 12 , 13 , 14 , 15 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Safety, Feasibility and Technical Considerations from a Prospective, Observational Study—CIREL: Irinotecan-TACE for CRLM in 152 Patients

Helmberger

Lucatelli

Pereira

et al. 2022

JCM

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CIREL, a prospective, Europe-wide, observational study aimed to assess the real-world feasibility and tolerability of irinotecan-based transarterial chemoembolization (LP-irinotecan TACE) for unresectable colorectal cancer liver metastases with regard to the treatment plan and adverse events (AEs). CIREL enrolled 152 eligible patients (≥18 years) with liver-only or dominant metastases treated with LP-irinotecan TACE following a multidisciplinary tumor board decision. Data were prospectively collected for baseline, the number of planned and performed sessions, and technical information and safety according to CTCAE 4.03/5.0. Results from 351 analyzed treatment sessions showed technical success for 99% of sessions, and 121 patients (79%) completed all planned sessions. Further, 60% of sessions were performed using opioids, 4% intra-arterial anesthetics, and 25% both. Additionally, 60% of patients experienced at least one peri-interventional AE of any grade; 8% of grade 3–4. Occurrence of AEs was related to larger liver-involvement (p < 0.001), bi-lobar disease (p = 0.002), and larger beads (p < 0.001). Using corticosteroids together with antiemetics showed reduced and lower grade vomiting (p = 0.01). LP-irinotecan TACE was tolerated well and had a high proportion of completed treatment plans. This minimally invasive locoregional treatment can be used together with concomitant systemic therapy or ablation.

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Transarterial Chemoembolization Alone or Followed by Bevacizumab for Treatment of Colorectal Liver Metastases

Cited by 2 publications

References 33 publications

Dynamic radiomics for predicting the efficacy of antiangiogenic therapy in colorectal liver metastases

Dynamic radiomics for predicting the efficacy of antiangiogenic therapy in colorectal liver metastases

Safety, Feasibility and Technical Considerations from a Prospective, Observational Study—CIREL: Irinotecan-TACE for CRLM in 152 Patients

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