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Item Type Journal Article
Title Prognostic value of the tumor-to-liver density ratio in patients with metastatic colorectal cancer treated with bevacizumab-based chemotherapy. A post-hoc study of the STIC-AVASTIN trial
Creator Mazard et al.
Author Thibault Mazard
Author Caroline Mollevi
Author Evelyne M. Loyer
Author Julie Léger
Author Romain Chautard
Author Olivier Bouché
Author Christophe Borg
Author Paul Armand-Dujardin
Author Aurore Bleuzen
Author Eric Assenat
Author Thierry Lecomte
Abstract BACKGROUND: The Response Evaluation Criteria in Solid Tumors (RECIST) are often inadequate for the early assessment of the response to cancer therapy, particularly bevacizumab-based chemotherapy. In a first cohort of patients with colorectal cancer liver metastases (CRLM), we showed that variations of the tumor-to-liver density (TTLD) ratio and modified size-based criteria determined using computed tomography (CT) data at the first restaging were better prognostic criteria than the RECIST. The aims of this study were to confirm the relevance of these radiological biomarkers as early predictors of the long-term clinical outcome and to assess their correlation with contrast-enhanced ultrasound (CEUS) parameters in a new patient cohort. METHODS: In this post-hoc study of the multicenter STIC-AVASTIN trial, we retrospectively reviewed CT data of patients with CRLM treated with bevacizumab-based regimens. We determined the size, density and TTLD ratio of target liver lesions at baseline and at the first restaging and also performed a morphologic evaluation according to the MD Anderson criteria. We assessed the correlation of these parameters with progression-free survival (PFS) and overall survival (OS) using the log-rank test and a Cox proportional hazard model. We also examined the association between TTLD ratio and quantitative CEUS parameters. RESULTS: This analysis concerned 79 of the 137 patients included in the STIC-AVASTIN trial. PFS and OS were significantly longer in patients with tumor size reduction?>?15% at first restaging, but were not correlated with TTLD ratio variations. However, PFS was longer in patients with TTLD ratio?>?0.6 at baseline and first restaging than in those who did not reach this threshold. In the multivariate analysis, only baseline TTLD ratio?>?0.6 was a significant survival predictor. TTLD ratio?>?0.6 was associated with improved perfusion parameters. CONCLUSIONS: Although TTLD ratio variations did not correlate with the long-term clinical outcomes, TTLD absolute values remained a good predictor of survival at baseline and first restaging, and may reflect tumor microvascular features that might influence bevacizumab-based treatment efficiency. TRIAL REGISTRATION: NCT00489697, registration number of the STIC-AVASTIN trial.
Publication Cancer Imaging: The Official Publication of the International Cancer Imaging Society
Volume 24
Issue 1
Pages 77
Date 2024-06-17
Journal Abbr Cancer Imaging
Language eng
DOI 10.1186/s40644-024-00722-7
ISSN 1470-7330
Library Catalog PubMed
Extra PMID: 38886836 PMCID: PMC11181627
Tags Adult, Aged, Antineoplastic Combined Chemotherapy Protocols, Bevacizumab, Colorectal Neoplasms, Female, Humans, Liver, Liver Neoplasms, Male, Middle Aged, Prognosis, Retrospective Studies, Tomography, X-Ray Computed
Date Added 2024/10/10 - 16:21:57
Date Modified 2024/10/10 - 16:21:57
Notes and Attachments PubMed entry (Attachment)


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