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Maniar R, Loehrer PJ. What Have We Learned from Molecularly Informed Clinical Trials on Thymomas and Thymic Carcinomas-Current Status and Future Directions? Cancers (Basel) 2024; 16:416. [PMID: 38254905 PMCID: PMC10813974 DOI: 10.3390/cancers16020416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
Thymic epithelial tumors (TETs), which include thymomas and thymic carcinomas, are a rare, heterogeneous group of malignancies that originate from the thymus gland. As an important organ of immune cell development, thymic tumors, particularly thymomas, are often associated with paraneoplastic autoimmune disorders. The advances in targeted therapies for both solid and hematologic malignancies have resulted in improved patient outcomes, including better and more durable efficacy and improved toxicity. Targeted therapies have also been investigated in the treatment of TETs, though the results have largely been modest. These have included somatostatin-receptor-targeting therapies, KIT- and EGFR-directed tyrosine kinase inhibitors, epigenetic modulators, anti-angiogenesis agents, and agents targeting the cell proliferation and survival pathways and cell cycle regulators. Numerous investigated treatments have failed or underperformed due to a lack of a strong biomarker of efficacy. Ongoing trials are attempting to expand on previous experiences, including the exploration of effective drugs in early-stage disease. Novel combination therapy strategies are also undergoing evaluation, with the goal of augmenting efficacy and understanding the toxicity while expanding the biomarkers of efficacy and safety. With advances in technology to improve target identification and drug delivery, old targets may become new opportunities, and the subsequently developed drugs may find their place in the treatment of thymic tumors.
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Affiliation(s)
| | - Patrick J. Loehrer
- Division of Hematology & Oncology, Indiana University School of Medicine, Indianapolis, IN 46202, USA;
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Zhou Z, Han X, Sun D, Liang Z, Wu W, Ju H. A Comprehensive Prognostic Model for Colorectal Cancer Liver Metastasis Recurrence After Neoadjuvant Chemotherapy. Front Oncol 2022; 12:855915. [PMID: 35785215 PMCID: PMC9245066 DOI: 10.3389/fonc.2022.855915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 05/17/2022] [Indexed: 12/03/2022] Open
Abstract
Background For patients with colorectal cancer liver metastases (CRLMs), it is important to stratify patients according to the risk of recurrence. This study aimed to validate the predictive value of some clinical, imaging, and pathology biomarkers and develop an operational prognostic model for patients with CRLMs with neoadjuvant chemotherapy (NACT) before the liver resection. Methods Patients with CRLMs accompanied with primary lesion and liver metastases lesion resection were enrolled into this study. A nomogram based on independent risk factors was identified by Kaplan–Meier analysis and multivariate Cox proportional hazard analysis. The predictive ability was evaluated by receiver operating characteristic (ROC) curves and decision curve analysis (DCA). Calibration plot were also used to explore the consistency between prediction and reality. Results A total of 118 patients were enrolled into the study. Multivariable Cox analysis found that histopathological growth patterns (HGPs) [Hazard Rate (HR) = 2.130], radiology response (stable disease vs. partial response, HR = 2.207; progressive disease vs. partial response, HR = 3.824), lymph node status (HR = 1.442), and age (HR = 0.576) were independent risk factors for disease-free survival (DFS) (p < 0.05). Corresponding nomogram was constructed on the basis of the above factors, demonstrating that scores ranging from 5 to 11 presented better prognosis than the scores of 0–4 (median DFS = 14.3 vs. 4.9 months, p < 0.0001). The area under ROC curves of the model for 1-, 2-, and 3-year DFS were 0.754, 0.705, and 0.666, respectively, and DCA confirmed that the risk model showed more clinical benefits than clinical risk score. Calibration plot for the probability of DFS at 1 or 3 years verified an optimal agreement between prediction and actual observation. In the course of our research, compared with pure NACT, a higher proportion of desmoplastic HGP (dHGP) was detected in patients treated with NACT plus cetuximab (p = 0.030), and the use of cetuximab was an independent factor for decreased replacement HGP (rHGP) and increased dHGP (p = 0.049). Conclusion Our model is concise, comprehensive, and high efficient, which may contribute to better predicting the prognosis of patients with CRLMs with NACT before the liver resection. In addition, we observed an unbalanced distribution of HGPs as well.
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Affiliation(s)
- Zhenyuan Zhou
- School of The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xin Han
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Diandian Sun
- School of The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhiying Liang
- School of The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Wei Wu
- Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
- *Correspondence: Haixing Ju, ; Wei Wu,
| | - Haixing Ju
- Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
- *Correspondence: Haixing Ju, ; Wei Wu,
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Rousseau B, Boukerma AK, Henriques J, Cohen R, Lucidarme O, Borg C, Tournigand C, Kim S, Bachet JB, Mazard T, Louvet C, Chibaudel B, Vernerey D, Andre T, Hulin A. Impact of trough concentrations of regorafenib and its major metabolites M-2 and M-5 on overall survival of chemorefractory metastatic colorectal cancer patients: Results from a multicentre GERCOR TEXCAN phase II study. Eur J Cancer 2022; 168:99-107. [PMID: 35489233 PMCID: PMC10492638 DOI: 10.1016/j.ejca.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 03/01/2022] [Accepted: 03/11/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE This prospective pharmacokinetic (PK) ancillary study of the TEXCAN phase II GERCOR trial of patients with chemorefractory metastatic colorectal cancer and treated with regorafenib (REGO) investigated correlations between overall survival (OS) and concentrations (C) of REGO and its active metabolites, M-2 and M-5. METHODS 55 patients received REGO 160 mg/day for 21 days of a 28-day cycle (NCT02699073). REGO, M-2, M-5 were measured by liquid chromatography-mass spectrometry assay on day 15 of cycle 1 (C1) and 2 (C2). We studied the association between OS and Cmin of REGO, M-2 and M-5 at C1 and their accumulations between C1 and C2. RESULTS Medians of C2/C1 M-2 and M-5 ratios were 0.82 (interquartile range 0.50-1.78) and 0.75 (interquartile range 0.41-1.93), respectively. Patients with C2/C1 M-2 ratio ≥ median had improved survival compared to those < median (12.6 versus 4.0 months, P = 0.023), corresponding to a 66% mortality risk reduction in multivariate analysis. The C2/C1 M-2 ratio correlated with C1 REGO+M-2+M-5 (Csum; P = 0.006). Restricted cubic spline analysis showed an increased OS benefit as the C2/C1 M-2 ratio raises and when C1 Csum ranged between 2.5 and 5.5 mg/L. Patients within the Csum range had a reduced incidence of serious adverse events and improved OS. CONCLUSIONS We identified PK parameters associated with a survival benefit in patients with metastatic colorectal cancer treated by REGO. OS and safety were favourable when C1 REGO+M-2+M-5 Csum ranged between 2.5 and 5.5 mg/L. These results pave the way for individual REGO dose modification strategies based on PK monitoring. CLINICAL TRIAL REFERENCE NCT02699073.
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Affiliation(s)
- Benoit Rousseau
- Department of Medical Oncology, Henri Mondor Hospital, APHP, Creteil, France; Memorial Sloan Kettering Cancer Center, New York, USA; Pharmacology Unit, Henri Mondor Hospital, APHP, Creteil, France; GERCOR, Paris, France.
| | | | - Julie Henriques
- Methodology and Quality of Life Unit, Department of Medical Oncology, University Hospital, Besançon, France; Bourgogne Franche-Comté University, INSERM, Etablissement Français Du Sang Bourgogne Franche-Comté, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, UMR1098, Besançon, France
| | - Romain Cohen
- GERCOR, Paris, France; Sorbonne University and Department of Medical Oncology, Saint-Antoine Hospital, Paris, France
| | - Olivier Lucidarme
- Sorbonne University and Radiology Unit, Pitié-Salpétrière Hospital, APHP, Paris, France
| | - Christophe Borg
- GERCOR, Paris, France; Department of Medical Oncology, Besancon University Hospital, Besancon, France
| | - Christophe Tournigand
- Department of Medical Oncology, Henri Mondor Hospital, APHP, Creteil, France; GERCOR, Paris, France
| | - Stefano Kim
- GERCOR, Paris, France; Department of Medical Oncology, Besancon University Hospital, Besancon, France
| | - Jean-Baptiste Bachet
- GERCOR, Paris, France; Sorbonne University and Pitié-Salpêtrière Hospital, Paris, France
| | - Thibault Mazard
- Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM U1194, Université de Montpellier, Institut Régional Du Cancer de Montpellier, Montpellier, France
| | - Christophe Louvet
- GERCOR, Paris, France; Institut Mutualiste Montsouris, Paris, France
| | - Benoist Chibaudel
- Medical Oncology, Institut Hospitalier Franco-Britannique-Levallois-Perret, France
| | - Dewi Vernerey
- GERCOR, Paris, France; Methodology and Quality of Life Unit, Department of Medical Oncology, University Hospital, Besançon, France; Bourgogne Franche-Comté University, INSERM, Etablissement Français Du Sang Bourgogne Franche-Comté, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, UMR1098, Besançon, France
| | - Thierry Andre
- GERCOR, Paris, France; Sorbonne University and Department of Medical Oncology, Saint-Antoine Hospital, Paris, France
| | - Anne Hulin
- Pharmacology Unit, Henri Mondor Hospital, APHP, Creteil, France; GERCOR, Paris, France
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Fleuren EDG, Terry RL, Meyran D, Omer N, Trapani JA, Haber M, Neeson PJ, Ekert PG. Enhancing the Potential of Immunotherapy in Paediatric Sarcomas: Breaking the Immunosuppressive Barrier with Receptor Tyrosine Kinase Inhibitors. Biomedicines 2021; 9:1798. [PMID: 34944614 PMCID: PMC8698536 DOI: 10.3390/biomedicines9121798] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 12/22/2022] Open
Abstract
Despite aggressive surgery, chemotherapy, and radiotherapy, survival of children and adolescents and young adults (AYAs) with sarcoma has not improved significantly in the past four decades. Immune checkpoint inhibitors (ICIs) are an exciting type of immunotherapy that offer new opportunities for the treatment of paediatric and AYA sarcomas. However, to date, most children do not derive a benefit from this type of treatment as a monotherapy. The immunosuppressive tumour microenvironment is a major barrier limiting their efficacy. Combinations of ICIs, such as anti-PD-1 therapy, with targeted molecular therapies that have immunomodulatory properties may be the key to breaking through immunosuppressive barriers and improving patient outcomes. Preclinical studies have indicated that several receptor tyrosine kinase inhibitors (RTKi) can alter the tumour microenvironment and boost the efficacy of anti-PD-1 therapy. A number of these combinations have entered phase-1/2 clinical trials, mostly in adults, and in most instances have shown efficacy with manageable side-effects. In this review, we discuss the status of ICI therapy in paediatric and AYA sarcomas and the rationale for co-treatment with RTKis. We highlight new opportunities for the integration of ICI therapy with RTK inhibitors, to improve outcomes for children with sarcoma.
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Affiliation(s)
- Emmy D. G. Fleuren
- Children’s Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Randwick 2031, Australia; (R.L.T.); (M.H.); (P.G.E.)
- School of Women’s and Children’s Health, UNSW Sydney, Randwick 2052, Australia
- Centre for Childhood Cancer Research, UNSW Sydney, Randwick 2031, Australia
| | - Rachael L. Terry
- Children’s Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Randwick 2031, Australia; (R.L.T.); (M.H.); (P.G.E.)
- School of Women’s and Children’s Health, UNSW Sydney, Randwick 2052, Australia
| | - Deborah Meyran
- Cancer Immunology Program, Peter MacCallum Cancer Centre, Melbourne 3000, Australia; (D.M.); (J.A.T.); (P.J.N.)
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne 3000, Australia
- Inserm, Université de Paris, U976 HIPI Unit, Institut de Recherche Saint-Louis, 75475 Paris, France
| | - Natacha Omer
- Translational Innate Immunotherapy, University of Queensland Diamantina Institute (UQDI), Brisbane 4102, Australia;
- Oncology Services Group, Queensland Children’s Hospital, Brisbane 4101, Australia
| | - Joseph A. Trapani
- Cancer Immunology Program, Peter MacCallum Cancer Centre, Melbourne 3000, Australia; (D.M.); (J.A.T.); (P.J.N.)
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne 3000, Australia
| | - Michelle Haber
- Children’s Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Randwick 2031, Australia; (R.L.T.); (M.H.); (P.G.E.)
- School of Women’s and Children’s Health, UNSW Sydney, Randwick 2052, Australia
| | - Paul J. Neeson
- Cancer Immunology Program, Peter MacCallum Cancer Centre, Melbourne 3000, Australia; (D.M.); (J.A.T.); (P.J.N.)
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne 3000, Australia
| | - Paul G. Ekert
- Children’s Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Randwick 2031, Australia; (R.L.T.); (M.H.); (P.G.E.)
- School of Women’s and Children’s Health, UNSW Sydney, Randwick 2052, Australia
- Centre for Childhood Cancer Research, UNSW Sydney, Randwick 2031, Australia
- Cancer Immunology Program, Peter MacCallum Cancer Centre, Melbourne 3000, Australia; (D.M.); (J.A.T.); (P.J.N.)
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne 3000, Australia
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne 3052, Australia
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Lucatelli P, Burrel M, Guiu B, de Rubeis G, van Delden O, Helmberger T. CIRSE Standards of Practice on Hepatic Transarterial Chemoembolisation. Cardiovasc Intervent Radiol 2021; 44:1851-1867. [PMID: 34694454 DOI: 10.1007/s00270-021-02968-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 09/04/2021] [Indexed: 12/15/2022]
Abstract
This CIRSE Standards of Practice document is aimed at interventional radiologists and provides best practices for performing transarterial chemoembolisation. It has been developed by an expert writing group under the guidance of the CIRSE Standards of Practice Committee. It will encompass all technical details reflecting European practice of different TACE procedures (Lp-TACE, DEM-TACE, DSM-TACE, b-TACE) as well as revising the existing literature on the various clinical indications (HCC, mCRC, ICC, NET). Finally, new frontiers of development will also be discussed.
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Affiliation(s)
- Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Rome, Italy.
| | - Marta Burrel
- Radiology Department, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Boris Guiu
- Department of Radiology, Montpellier School of Medicine, St-Eloi University Hospital, Montpellier, France
| | - Gianluca de Rubeis
- Vascular and Interventional Radiology Unit, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Rome, Italy
- Department of Diagnostic Radiology, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Otto van Delden
- Department of Interventional Radiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Thomas Helmberger
- Institute for Diagnostic and Interventional Radiology and Neuroradiology, Bogenhausen Hospital, Munich, Germany
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Pastor B, André T, Henriques J, Trouilloud I, Tournigand C, Jary M, Mazard T, Louvet C, Azan S, Bauer A, Roch B, Sanchez C, Vernerey D, Thierry AR, Adenis A. Monitoring levels of circulating cell-free DNA in patients with metastatic colorectal cancer as a potential biomarker of responses to regorafenib treatment. Mol Oncol 2021; 15:2401-2411. [PMID: 33934494 PMCID: PMC8410523 DOI: 10.1002/1878-0261.12972] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/09/2021] [Accepted: 04/20/2021] [Indexed: 12/25/2022] Open
Abstract
Circulating cell‐free DNA (cfDNA) contains circulating tumor DNA (ctDNA), which can be obtained from serial liquid biopsies to enable tumor genome analysis throughout the course of treatment. We investigated cfDNA and mutant ctDNA as potential biomarkers to predict the best outcomes of regorafenib‐treated metastatic colorectal cancer (mCRC) patients. We analyzed longitudinally collected plasma cfDNA of 43 mCRC patients prospectively enrolled in the phase II TEXCAN trial by IntPlex qPCR. Qualitative (KRAS, NRAS, BRAFV600E mutations) and quantitative (total cfDNA concentration, mutant ctDNA concentration, mutant ctDNA fraction) parameters were correlated with overall survival (OS) and progression‐free survival (PFS). When examined as classes or continuous variables, the concentrations of total cfDNA, mutant ctDNA, and, partly, mutant ctDNA fraction prior to regorafenib treatment correlated with OS. Patients with baseline cfDNA > 26 ng·mL−1 had shorter OS than those with cfDNA value below this threshold (4.0 vs 6.9 months; log‐rank P = 0.0366). Patients with baseline mutant ctDNA > 2 ng·mL−1 had shorter OS than those with mutant ctDNA below this threshold (log‐rank P = 0.0154). We show that pretreatment cfDNA and mutant ctDNA levels may identify mCRC patients that may benefit from regorafenib treatment.
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Affiliation(s)
- Brice Pastor
- Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM, Université de Montpellier, Montpellier Cancer Institute (ICM), France
| | - Thierry André
- Department of Medical Oncology, Saint-Antoine University Hospital, Sorbonne University, Paris, France.,Oncology Multidisciplinary Research Group (GERCOR), Paris, France
| | - Julie Henriques
- Methodology and Quality of Life Unit in Oncology, Besançon University Hospital, France
| | - Isabelle Trouilloud
- Department of Medical Oncology, Saint-Antoine University Hospital, Sorbonne University, Paris, France.,Oncology Multidisciplinary Research Group (GERCOR), Paris, France
| | - Christophe Tournigand
- Oncology Multidisciplinary Research Group (GERCOR), Paris, France.,Medical Oncology Service, Henri Mondor Hospital, AP-HP, Université Paris Est Créteil Créteil, France
| | - Marine Jary
- Oncology Multidisciplinary Research Group (GERCOR), Paris, France.,INSERM, Etablissement Français du Sang Bourgogne Franche-Comté, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Bourgogne Franche-Comté University, Besançon, France.,Department of Medical Oncology, Besançon University Hospital, France
| | - Thibault Mazard
- Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM, Université de Montpellier, Montpellier Cancer Institute (ICM), France.,Department of Medical Oncology, Montpellier Cancer Institute (ICM), France
| | - Christophe Louvet
- Oncology Multidisciplinary Research Group (GERCOR), Paris, France.,Department of Medical Oncology, Institut Monsouris, Paris, France
| | - Simon Azan
- Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM, Université de Montpellier, Montpellier Cancer Institute (ICM), France
| | - Audrey Bauer
- Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM, Université de Montpellier, Montpellier Cancer Institute (ICM), France
| | - Benoit Roch
- Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM, Université de Montpellier, Montpellier Cancer Institute (ICM), France.,Department of Thoracic Oncology, Montpellier University Hospital, Université de Montpellier, France
| | - Cynthia Sanchez
- Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM, Université de Montpellier, Montpellier Cancer Institute (ICM), France
| | - Dewi Vernerey
- Oncology Multidisciplinary Research Group (GERCOR), Paris, France.,Methodology and Quality of Life Unit in Oncology, Besançon University Hospital, France
| | - Alain R Thierry
- Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM, Université de Montpellier, Montpellier Cancer Institute (ICM), France.,Department of Medical Oncology, Montpellier Cancer Institute (ICM), France
| | - Antoine Adenis
- Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM, Université de Montpellier, Montpellier Cancer Institute (ICM), France.,Department of Medical Oncology, Montpellier Cancer Institute (ICM), France
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Li L, Xu Y, Yang Y, Ye F, Zhang H, Zhou A, Zhao X. RECIST 1.1, Choi and mChoi criteria in the evaluation of tumor response in patients with metastatic colorectal cancer treated with Regorafenib and anti-PD-1 antibody. Eur J Radiol 2021; 141:109823. [PMID: 34146911 DOI: 10.1016/j.ejrad.2021.109823] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/20/2021] [Accepted: 06/09/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE No comparative study on evaluating performance of radiological criteria has been investigated in metastatic colorectal cancer (mCRC) patients treated with the combination of Regorafenib and anti-programmed cell death 1(PD-1) antibody. We aimed to compare the performance of different radiological criteria in evaluating response in mCRC patients treated with the combination of Regorafenib plus anti-PD-1 antibody. METHOD We retrospectively recruited patients treated with Regorafenib and anti-PD-1 antibody in a single institution. Baseline and the first tumor evaluation of contrast-enhanced computed tomography (CE-CT) were assessed by three evaluation criteria: RECIST 1.1, Choi, modified Choi (mChoi). Overall survival (OS) was defined as endpoint event. RESULTS Twenty-three mCRC patients [age: 58.8 ± 10.6 years, 18 (78.3 %) males] were assessed. The median overall survival was 11.8 months. According to RECIST 1.1, 8 (34.8 %) patients were stable disease (SD) and 15 (65.2 %) were progressive disease (PD). According to Choi and mChoi, 5 (21.7 %) and 1(4.3 %) patient was responders, respectively. All non-PD patients showed significantly better overall survival than PD patients by all criteria. According to Choi, those identified as responders showed better overall survival than non-responders though significant statistics were not reached (P=0.262). CONCLUSIONS RECIST 1.1, Choi and mChoi criteria could identify survival benefit from Regorafenib plus anti-PD-1 antibody in mCRC patients. However, the value of responders detected by Choi remains to be validated in further studies.
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Affiliation(s)
- Lu Li
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, 100021, China
| | - Ying Xu
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, 100021, China
| | - Yi Yang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, 100021, China; Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, 100021, China
| | - Feng Ye
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, 100021, China.
| | - Hongmei Zhang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, 100021, China
| | - Aiping Zhou
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, 100021, China.
| | - Xinming Zhao
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, 100021, China
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Zopfs D, Reimer RP, Sonnabend K, Rinneburger M, Hentschke CM, Persigehl T, Lennartz S, Große Hokamp N. Intraindividual Consistency of Iodine Concentration in Dual-Energy Computed Tomography of the Chest and Abdomen. Invest Radiol 2021; 56:181-187. [PMID: 32932376 DOI: 10.1097/rli.0000000000000724] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Dual-energy computed tomography (DECT)-derived quantification of iodine concentration (IC) is increasingly used in oncologic imaging to characterize lesions and evaluate treatment response. However, only limited data are available on intraindividual consistency of IC and its variation. This study investigates the longitudinal reproducibility of IC in organs, vessels, and lymph nodes in a large cohort of healthy patients who underwent repetitive DECT imaging. MATERIALS AND METHODS A total of 159 patients, who underwent a total of 469 repetitive (range, 2-4), clinically indicated portal-venous phase DECT examinations of the chest and abdomen, were retrospectively included. At time of imaging, macroscopic tumor burden was excluded by follow-up imaging (≥3 months). Iodine concentration was measured region of interest-based (N = 43) in parenchymatous organs, vessels, lymph nodes, and connective tissue. Normalization of IC to the aorta and to the trigger delay as obtained from bolus tracking was performed. For statistical analysis, intraclass correlation coefficient and modified variation coefficient (MVC) were used to assess intraindividual agreement of IC and its variation between different time points, respectively. Furthermore, t tests and analysis of variance with Tukey-Kramer post hoc test were used. RESULTS The mean intraclass correlation coefficient over all regions of interest was good to excellent (0.642-0.936), irrespective of application of normalization or the normalization technique. Overall, MVC ranged from 1.8% to 25.4%, with significantly lower MVC in data normalized to the aorta (5.8% [1.8%-15.8%]) in comparison with the MVC of not normalized data and data normalized to the trigger delay (P < 0.01 and P = 0.04, respectively). CONCLUSIONS Our study confirms intraindividual, longitudinal variation of DECT-derived IC, which varies among vessels, lymph nodes, organs, and connective tissue, following different perfusion characteristics; normalizing to the aorta seems to improve reproducibility when using a constant contrast media injection protocol.
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Affiliation(s)
- David Zopfs
- From the Faculty of Medicine, University Cologne, and Institute for Diagnostic and Interventional Radiology, University Hospital Cologne, Germany
| | - Robert Peter Reimer
- From the Faculty of Medicine, University Cologne, and Institute for Diagnostic and Interventional Radiology, University Hospital Cologne, Germany
| | - Kristina Sonnabend
- From the Faculty of Medicine, University Cologne, and Institute for Diagnostic and Interventional Radiology, University Hospital Cologne, Germany
| | - Miriam Rinneburger
- From the Faculty of Medicine, University Cologne, and Institute for Diagnostic and Interventional Radiology, University Hospital Cologne, Germany
| | | | - Thorsten Persigehl
- From the Faculty of Medicine, University Cologne, and Institute for Diagnostic and Interventional Radiology, University Hospital Cologne, Germany
| | | | - Nils Große Hokamp
- From the Faculty of Medicine, University Cologne, and Institute for Diagnostic and Interventional Radiology, University Hospital Cologne, Germany
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