Early tumor shrinkage and response assessment according to mRECIST predict overall survival in hepatocellular carcinoma patients under sorafenib

Cancer Imaging

Enrico N. de Toni¹  Peter Malfertheiner¹  Kerstin Schütte²  Otto van Delden³  Bernhard Gebauer⁴  Regina Schinner⁵  Max Seidensticker⁵  Jens Ricke⁵  Osman Öcal⁵  Vincent Vandecaveye⁶  Irene Bargellini⁷  Maciej Pech⁸  Antonio Gasbarrini⁹  Bruno Sangro^1,10  Christian Sengel^1,11  Christoph J. Zech^1,12  Christian Loewe^1,13 

[1] Department of Internal Medicine II, University Hospital, LMU Munich, Munich, Germany;Department of Internal Medicine and Gastroenterology, Niels-Stensen-Kliniken Marienhospital, Osnabrück, Germany;Department of Radiology and Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;Department of Radiology, Charité – University Medicine Berlin, Berlin, Germany;Department of Radiology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany;Department of Radiology, University Hospitals Leuven, Leuven, Belgium;Department of Vascular and Interventional Radiology, University Hospital of Pisa, Pisa, Italy;Departments of Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, Germany;Gastroenterology, Gemelli Foundation, Catholic University, Rome, Italy;Liver Unit, Clínica Universidad de Navarra, Pamplona, Spain;Radiology Department, Grenoble University Hospital, La Tronche, France;Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland;Section of Cardiovascular and Interventional Radiology, Department of Bioimaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria;

关键词: Hepatocellular carcinoma;    Sorafenib;    mRECIST;    Early tumor shrinkage;    Objective response;   

DOI  :  10.1186/s40644-021-00439-x

来源: Springer

【 摘 要 】

BackgroundThe aim of this study was to explore the relationship between follow-up imaging characteristics and overall survival (OS) in advanced hepatocellular carcinoma (HCC) patients under sorafenib treatment.MethodsAssociations between OS and objective response (OR) by mRECIST or early tumor shrinkage (ETS; ≥20% reduction in enhancing tumor diameter at the first follow-up imaging) were analyzed in HCC patients treated with sorafenib within a multicenter phase II trial (SORAMIC). 115 patients were included in this substudy. The relationship between survival and OR or ETS were explored. Landmark analyses were performed according to OR at fixed time points. Cox proportional hazards models with OR and ETS as a time-dependent covariate were used to compare survival with factors known to influence OS.ResultsThe OR rate was 29.5%. Responders had significantly better OS than non-responders (median 30.3 vs. 11.4 months; HR, 0.38 [95% CI, 0.22–0.63], p < 0.001), and longer progression-free survival (PFS; median 10.1 vs. 4.3 months, p = 0.015). Patients with ETS ≥ 20% had longer OS (median 22.1 vs. 11.4 months, p = 0.002) and PFS (median 8.0 vs. 4.3 months, p = 0.034) than patients with ETS < 20%. Besides OR and ETS, male gender, lower bilirubin and ALBI grade were associated with improved OS in univariate analysis. Separate models of multivariable analysis confirmed OR and ETS as independent predictors of OS.ConclusionOR according to mRECIST and ETS in patients receiving sorafenib treatment are independent prognostic factors for OS. These parameters can be used for assessment of treatment benefit and optimal treatment sequencing in patients with advanced HCC.

【 授权许可】

CC BY