Correlation of RECIST, Computed Tomography Morphological Response, and Pathological Regression in Hepatic Metastasis Secondary to Colorectal Cancer: The AVAMET Study

Cancers

Joan Figueras¹  Carles Pericay²  Ruth Vera³  Antonio Viúdez³  Mercedes Salgado⁴  Juan Manuel Campos⁵  Miguel Marín⁶  Pilar García-Alfonso⁷  María José Safont⁸  Jose María Vieitez⁹  Adelaida Lacasta^1,10  Juan Carlos Cámara^1,11  Virginia Martínez^1,12  Ana Ruiz-Casado^1,13  Esther Falcó^1,14  Jorge Aparicio^1,15  Mónica Jorge^1,16  Clara Montagut^1,17  Marta Martín-Richard^1,18  María Luisa Gómez^1,19  Juan Ramón Ayuso^2,20 

[1] General and digestive surgery Department, Hospital Universitario Josep Trueta, 17007 Girona, Spain;Medical Oncology Department, C.S. Parc Taulí, 08208 Sabadell, Spain;Medical Oncology Department, Complejo Hospitalario de Navarra, Instituto de investigaciones Sanitarias de Navarra (IdISNA), 31008 Pamplona, Spain;Medical Oncology Department, Complejo Hospitalario de Ourense, 32005 Ourense, Spain;Medical Oncology Department, Hospital Arnau de Vilanova, 46015 Valencia, Spain;Medical Oncology Department, Hospital Clínico Universitario de la Arrixaca, 30120 Murcia, Spain;Medical Oncology Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain;Medical Oncology Department, Hospital General Universitario de Valencia, 46014 Valencia, Spain;Medical Oncology Department, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain;Medical Oncology Department, Hospital Universitario Donostia, 20014 San Sebastian, Spain;Medical Oncology Department, Hospital Universitario Fundación Alcorcón, 28922 Madrid, Spain;Medical Oncology Department, Hospital Universitario La Paz, 28046 Madrid, Spain;Medical Oncology Department, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Spain;Medical Oncology Department, Hospital Universitario Son Llàtzer, 07198 Palma de Mallorca, Spain;Medical Oncology Department, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain;Medical Oncology Department, Hospital Xeral Cíes, 36204 Vigo, Spain;Medical Oncology Department, Hospital de Mar, 08003 Barcelona, Spain;Medical Oncology Department, Hospital la Santa Creu i Sant Pau, 08041 Barcelona, Spain;Pathology Department, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain;Radiology Department, Hospital Clínic de Barcelona, 08036 Barcelona, Spain;

关键词: metastatic colorectal cancer;    neoadjuvant chemotherapy;    bevacizumab;    antiangiogenics;    computed tomography-based morphological criteria;   

DOI  :  10.3390/cancers12082259

来源: DOAJ

【 摘 要 】

Background: The prospective phase IV AVAMET study was undertaken to correlate response evaluation criteria in solid tumors (RECIST)-defined response rates with computed tomography-based morphological criteria (CTMC) and pathological response after liver resection of colorectal cancer metastases. Methods: Eligible patients were aged ≥18 years, with Eastern Cooperative Oncology Group (ECOG) performance status 0/1 and histologically-confirmed colon or rectal adenocarcinoma with measurable liver metastases. Preoperative treatment was bevacizumab (7.5 mg on day 1) + XELOX (oxaliplatin 130 mg/m², capecitabine 1000 mg/m² bid on days 1–14 q3w). After three cycles, response was evaluated by a multidisciplinary team. Patients who were progression-free and metastasectomy candidates received one cycle of XELOX before undergoing surgery 3–5 weeks later, followed by four cycles of bevacizumab + XELOX. Results: A total of 83 patients entered the study; 68 were eligible for RECIST, 67 for CTMC, and 51 for pathological response evaluation. Of these patients, 49% had a complete or partial RECIST response, 91% had an optimal or incomplete CTMC response, and 81% had a complete or major pathological response. CTMC response predicted 37 of 41 pathological responses versus 23 of 41 responses predicted using RECIST (p = 0.008). Kappa coefficients indicated a lack of correlation between the results of RECIST and morphological responses and between morphological and pathological response rates. Conclusion: CTMC may represent a better marker of pathological response to bevacizumab + XELOX than RECIST in patients with potentially-resectable CRC liver metastases.

【 授权许可】

Unknown