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Войти в исследования Total tumor volume predicts overall survival and response to induction chemotherapy in patients with colorectal cancer liver metastases: An ancillary study of the phase 3 CAIRO5 trial.
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Michiel Zeeuw J, Kemna Ruby, Ali Mahsoem, van Eck Sophie, Wesdorp Nina J, Roor Joran, van Waesberghe Jan Hein T M, van den Bergh Janneke E, Nota Irene M G C, Moos Shira I, van Dieren Susan, van Amerongen Martinus J, Bond Marinde J G, Chapelle Thiery, van Dam Ronald M, Engelbrecht Marc R W, Gerhards Michael F, Grunhagen Dirk J, van Gulik Thomas M, Hermans John J, de Jong Koert P, Klaase Joost M, Kok Niels F M, Leclercq Wouter K G, Liem Mike S L, van Lienden Krijn P, Quintus Molenaar I, Patijn Gijs A, Rijken Arjen M, Ruers Theo M, Verhoef Cornelis, de Wilt Johannes H W, Buffart Tineke E, Swijnenburg Rutger-Jan, Punt Cornelis J A, Verpalen Inez M, Stoker Jaap, Huiskens Joost, Kazemier Geert, CAIRO5 research group
Аннотация
METHODS: Patients with initially unresectable liver-only CRLM from the phase 3 CAIRO5 trial (NCT02162563) were included. All patients received induction systemic treatment. Baseline TTV and changes in TTV and RECIST1.1 in response to systemic treatment were calculated using the CT scans before systemic treatment and at first follow-up, and were assessed for their prognostic and predictive value with multivariable Cox regression models. Results In total, 425 patients were included. In multivariable analyses, baseline TTV (adjusted HR [aHR] for 100 mL vs 10 mL, 2.44 [95 % CI, 1.25-4.76]; P = 0.006) and relative change in TTV were the strongest predictors for OS (aHR for 0 % change vs 50 % decrease, 2.57 [1.83-3.60]; P < 0.0001). In contrast, RECIST1.1 was not independently associated with OS (aHR for partial response vs progressive disease, 0.63 [95 % CI, 0.33-1.20]). Higher baseline TTV predicted a stronger treatment benefit of FOLFOX-/FOLFIRI-bevacizumab vs FOLFOX-/FOLFIRI-panitumumab on OS (Pinteraction=0.017).
CONCLUSION: This study demonstrates that TTV (i) outperforms traditional risk factors for OS prognostication, and (ii) may be a more accurate and sensitive treatment response assessment method compared to the currently used RECIST1.1 system in patients with initially unresectable CRLM. Moreover, TTV assessment is a promising approach for individualized clinical decision-making between bevacizumab and panitumumab.