Visceral fat area is an independent predictive biomarker of outcome after first-line bevacizumab-based treatment in metastatic colorectal cancer

Abstract

This study provides the first evidence that high VFA independently predicts a poorer outcome in patients given first-line bevacizumab-based treatment for MCC. However, this predictive biomarker needs to be validated in a different dataset.

Quantitative measurement of adiposity using CT images to predict the benefit of bevacizumab-based chemotherapy in epithelial ovarian cancer patients

“…However, the lack of effective prognostic prediction markers to stratify the patients remains a major challenge to establish an optimal personalized treatment paradigm of using these antiangiogenic agents to date. In a continuous effort to identify more effective prognostic markers, 'adiposity' has recently attracted research interest as a potential clinical biomarker to evaluate the efficacy of applying VEGF-targeted antiangiogenic therapy to treat a variety of cancers, including colon cancer (7,19), renal cell carcinoma (20,21) and ovarian cancer (9). However, previous studies generated somehow conflicting results (7,19,20,21).…”

“…Maintenance bevacizumab (%) Percentage of SFA to whole body size f 3 Percentage of VFA to whole body size f 4 Mean CT number (pixel value) of SFA f 5 SD of the CT number of SFA f 6 Mean CT number (pixel value) of VFA f 7 SD of the CT number of VFA f 8 Size (volume) ratio between SFA and VFA BMI, body mass index; CT, computed tomography; ID, identity; SFA, subcutaneous fat area; VFA, visceral fat area; SD, standard deviation.…”

“…The results of those studies revealed that certain groups of EOC patients, such as those with high risk of disease progression, may benefit from bevacizumab therapy by increasing their progression-free survival (PFS) and/or overall survival (OS) (4), while other groups of EOC patients may not be suitable for receiving bevacizumab-based chemotherapy due to its high toxicity levels and other serious adverse events (6). For example, a fraction of EOC patients with obesity usually have poor response to bevacizumab-based chemotherapy, including short PFS and OS (7). As a result, how to rationally identify EOC patients who are most likely to benefit from receiving bevacizumab and/or other antiangiogenic therapies remains one of the unsolved critical issues in treating EOC patients (8).…”

Is obesity an advantage in patients with colorectal cancer?

“…However, other studies have shown contradictory results, postulating decreased efficacy of bevacizumab in obese patients [13,20,21]. In fact, response rates, time to progression as well as survival was worse in patients receiving bevacizumab with a higher BMI [21]. The authors speculate it might be higher circulating levels of VEGF conferring resistance to bevacizumab alongside higher volume of distribution in obese patients [13].…”

“…This might explain slightly better outcomes in obese patients receiving bevacizumab in our cohort of patients evaluated. However, other studies have shown contradictory results, postulating decreased efficacy of bevacizumab in obese patients [13,20,21]. In fact, response rates, time to progression as well as survival was worse in patients receiving bevacizumab with a higher BMI [21].…”