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Standard diametric versus volumetric early tumor shrinkage as a predictor of survival in metastatic colorectal cancer: subgroup findings of the randomized, open-label phase III trial FIRE-3 / AIO KRK-0306

OBJECTIVES: Early tumor shrinkage (ETS) quantifies the objective response at the first assessment during systemic treatment. In metastatic colorectal cancer (mCRC), ETS gains relevance as an early available surrogate for patient survival. The aim of this study was to increase the predictive accuracy...

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Autores principales: Hofmann, Felix O., Heinemann, Volker, D’Anastasi, Melvin, Gesenhues, Alena B., Hesse, Nina, von Weikersthal, Ludwig Fischer, Decker, Thomas, Kiani, Alexander, Moehler, Markus, Kaiser, Florian, Heintges, Tobias, Kahl, Christoph, Kullmann, Frank, Scheithauer, Werner, Link, Hartmut, Modest, Dominik P., Stintzing, Sebastian, Holch, Julian W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9889429/
https://www.ncbi.nlm.nih.gov/pubmed/35976398
http://dx.doi.org/10.1007/s00330-022-09053-2
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author Hofmann, Felix O.
Heinemann, Volker
D’Anastasi, Melvin
Gesenhues, Alena B.
Hesse, Nina
von Weikersthal, Ludwig Fischer
Decker, Thomas
Kiani, Alexander
Moehler, Markus
Kaiser, Florian
Heintges, Tobias
Kahl, Christoph
Kullmann, Frank
Scheithauer, Werner
Link, Hartmut
Modest, Dominik P.
Stintzing, Sebastian
Holch, Julian W.
author_facet Hofmann, Felix O.
Heinemann, Volker
D’Anastasi, Melvin
Gesenhues, Alena B.
Hesse, Nina
von Weikersthal, Ludwig Fischer
Decker, Thomas
Kiani, Alexander
Moehler, Markus
Kaiser, Florian
Heintges, Tobias
Kahl, Christoph
Kullmann, Frank
Scheithauer, Werner
Link, Hartmut
Modest, Dominik P.
Stintzing, Sebastian
Holch, Julian W.
author_sort Hofmann, Felix O.
collection PubMed
description OBJECTIVES: Early tumor shrinkage (ETS) quantifies the objective response at the first assessment during systemic treatment. In metastatic colorectal cancer (mCRC), ETS gains relevance as an early available surrogate for patient survival. The aim of this study was to increase the predictive accuracy of ETS by using semi-automated volumetry instead of standard diametric measurements. METHODS: Diametric and volumetric ETS were retrospectively calculated in 253 mCRC patients who received 5-fluorouracil, leucovorin, and irinotecan (FOLFIRI) combined with either cetuximab or bevacizumab. The association of diametric and volumetric ETS with overall survival (OS) and progression-free survival (PFS) was compared. RESULTS: Continuous diametric and volumetric ETS predicted survival similarly regarding concordance indices (p > .05). In receiver operating characteristics, a volumetric threshold of 45% optimally identified short-term survivors. For patients with volumetric ETS ≥ 45% (vs < 45%), median OS was longer (32.5 vs 19.0 months, p < .001) and the risk of death reduced for the first and second year (hazard ratio [HR] = 0.25, p < .001, and HR = 0.39, p < .001). Patients with ETS ≥ 45% had a reduced risk of progressive disease only for the first 6 months (HR = 0.26, p < .001). These survival times and risks were comparable to those of diametric ETS ≥ 20% (vs < 20%). CONCLUSIONS: The accuracy of ETS in predicting survival was not increased by volumetric instead of diametric measurements. Continuous diametric and volumetric ETS similarly predicted survival, regardless of whether patients received cetuximab or bevacizumab. A volumetric ETS threshold of 45% and a diametric ETS threshold of 20% equally identified short-term survivors. KEY POINTS: • ETS based on volumetric measurements did not predict survival more accurately than ETS based on standard diametric measurements. • Continuous diametric and volumetric ETS predicted survival similarly in patients receiving FOLFIRI with cetuximab or bevacizumab. • A volumetric ETS threshold of 45% and a diametric ETS threshold of 20% equally identified short-term survivors. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00330-022-09053-2.
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spelling pubmed-98894292023-02-02 Standard diametric versus volumetric early tumor shrinkage as a predictor of survival in metastatic colorectal cancer: subgroup findings of the randomized, open-label phase III trial FIRE-3 / AIO KRK-0306 Hofmann, Felix O. Heinemann, Volker D’Anastasi, Melvin Gesenhues, Alena B. Hesse, Nina von Weikersthal, Ludwig Fischer Decker, Thomas Kiani, Alexander Moehler, Markus Kaiser, Florian Heintges, Tobias Kahl, Christoph Kullmann, Frank Scheithauer, Werner Link, Hartmut Modest, Dominik P. Stintzing, Sebastian Holch, Julian W. Eur Radiol Oncology OBJECTIVES: Early tumor shrinkage (ETS) quantifies the objective response at the first assessment during systemic treatment. In metastatic colorectal cancer (mCRC), ETS gains relevance as an early available surrogate for patient survival. The aim of this study was to increase the predictive accuracy of ETS by using semi-automated volumetry instead of standard diametric measurements. METHODS: Diametric and volumetric ETS were retrospectively calculated in 253 mCRC patients who received 5-fluorouracil, leucovorin, and irinotecan (FOLFIRI) combined with either cetuximab or bevacizumab. The association of diametric and volumetric ETS with overall survival (OS) and progression-free survival (PFS) was compared. RESULTS: Continuous diametric and volumetric ETS predicted survival similarly regarding concordance indices (p > .05). In receiver operating characteristics, a volumetric threshold of 45% optimally identified short-term survivors. For patients with volumetric ETS ≥ 45% (vs < 45%), median OS was longer (32.5 vs 19.0 months, p < .001) and the risk of death reduced for the first and second year (hazard ratio [HR] = 0.25, p < .001, and HR = 0.39, p < .001). Patients with ETS ≥ 45% had a reduced risk of progressive disease only for the first 6 months (HR = 0.26, p < .001). These survival times and risks were comparable to those of diametric ETS ≥ 20% (vs < 20%). CONCLUSIONS: The accuracy of ETS in predicting survival was not increased by volumetric instead of diametric measurements. Continuous diametric and volumetric ETS similarly predicted survival, regardless of whether patients received cetuximab or bevacizumab. A volumetric ETS threshold of 45% and a diametric ETS threshold of 20% equally identified short-term survivors. KEY POINTS: • ETS based on volumetric measurements did not predict survival more accurately than ETS based on standard diametric measurements. • Continuous diametric and volumetric ETS predicted survival similarly in patients receiving FOLFIRI with cetuximab or bevacizumab. • A volumetric ETS threshold of 45% and a diametric ETS threshold of 20% equally identified short-term survivors. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00330-022-09053-2. Springer Berlin Heidelberg 2022-08-17 2023 /pmc/articles/PMC9889429/ /pubmed/35976398 http://dx.doi.org/10.1007/s00330-022-09053-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Oncology
Hofmann, Felix O.
Heinemann, Volker
D’Anastasi, Melvin
Gesenhues, Alena B.
Hesse, Nina
von Weikersthal, Ludwig Fischer
Decker, Thomas
Kiani, Alexander
Moehler, Markus
Kaiser, Florian
Heintges, Tobias
Kahl, Christoph
Kullmann, Frank
Scheithauer, Werner
Link, Hartmut
Modest, Dominik P.
Stintzing, Sebastian
Holch, Julian W.
Standard diametric versus volumetric early tumor shrinkage as a predictor of survival in metastatic colorectal cancer: subgroup findings of the randomized, open-label phase III trial FIRE-3 / AIO KRK-0306
title Standard diametric versus volumetric early tumor shrinkage as a predictor of survival in metastatic colorectal cancer: subgroup findings of the randomized, open-label phase III trial FIRE-3 / AIO KRK-0306
title_full Standard diametric versus volumetric early tumor shrinkage as a predictor of survival in metastatic colorectal cancer: subgroup findings of the randomized, open-label phase III trial FIRE-3 / AIO KRK-0306
title_fullStr Standard diametric versus volumetric early tumor shrinkage as a predictor of survival in metastatic colorectal cancer: subgroup findings of the randomized, open-label phase III trial FIRE-3 / AIO KRK-0306
title_full_unstemmed Standard diametric versus volumetric early tumor shrinkage as a predictor of survival in metastatic colorectal cancer: subgroup findings of the randomized, open-label phase III trial FIRE-3 / AIO KRK-0306
title_short Standard diametric versus volumetric early tumor shrinkage as a predictor of survival in metastatic colorectal cancer: subgroup findings of the randomized, open-label phase III trial FIRE-3 / AIO KRK-0306
title_sort standard diametric versus volumetric early tumor shrinkage as a predictor of survival in metastatic colorectal cancer: subgroup findings of the randomized, open-label phase iii trial fire-3 / aio krk-0306
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9889429/
https://www.ncbi.nlm.nih.gov/pubmed/35976398
http://dx.doi.org/10.1007/s00330-022-09053-2
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