Correlation of RECIST, Computed Tomography Morphological Response, and Pathological Regression in Hepatic Metastasis Secondary to Colorectal Cancer: The AVAMET Study
Por:
Vera, R, Gomez, M, Ayuso, J, Figueras, J, Garcia-Alfonso, P, Martinez, V, Lacasta, A, Ruiz-Casado, A, Safont, M, Aparicio, J, Campos, J, Camara, J, Martin-Richard, M, Montagut, C, Pericay, C, Vieitez, J, Falco, E, Jorge, M, Marin, M, Salgado, M and Viudez, A
Publicada:
1 ago 2020
Resumen:
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/m(2), capecitabine 1000 mg/m(2)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.
Filiaciones:
Vera, R:
Complejo Hosp Navarra, Inst Invest Sanitarias Navarra IdISNA, Med Oncol Dept, Pamplona 31008, Spain
Gomez, M:
Complejo Hosp Navarra, Pathol Dept, Pamplona 31008, Spain
Ayuso, J:
Hosp Clin Barcelona, Radiol Dept, Barcelona 08036, Spain
Figueras, J:
Hosp Univ Josep Trueta, Gen & Digest Surg Dept, Girona 17007, Spain
Garcia-Alfonso, P:
Hosp Gen Univ Gregorio Maranon, Med Oncol Dept, Madrid 28007, Spain
Martinez, V:
Hosp Univ La Paz, Med Oncol Dept, Madrid 28046, Spain
Lacasta, A:
Hosp Univ Donostia, Med Oncol Dept, San Sebastian 20014, Spain
Ruiz-Casado, A:
Hosp Univ Puerta de Hierro, Med Oncol Dept, Majadahonda 28222, Spain
Safont, M:
Hosp Gen Univ Valencia, Med Oncol Dept, Valencia 46014, Spain
Aparicio, J:
Hosp Univ & Politecn La Fe, Med Oncol Dept, Valencia 46026, Spain
:
Hosp Arnau Vilanova, Med Oncol Dept, Valencia 46015, Spain
Camara, J:
Hosp Univ Fdn Alcorcon, Med Oncol Dept, Madrid 28922, Spain
Martin-Richard, M:
Hosp Santa Creu & Sant Pau, Med Oncol Dept, Barcelona 08041, Spain
Montagut, C:
Hosp Mar, Med Oncol Dept, Spain Tacramtulasedcrap TugatnoMC, Barcelona 08003, Spain
Pericay, C:
CS Parc Tauli, Med Oncol Dept, Sabadell 08208, Spain
Vieitez, J:
Hosp Univ Cent Asturias, Med Oncol Dept, Oviedo 33011, Spain
Falco, E:
Hosp Univ Son Llatzer, Med Oncol Dept, Palma De Mallorca 07198, Spain
Jorge, M:
Hosp Xeral Cies, Med Oncol Dept, Vigo 36204, Spain
Marin, M:
Hosp Clin Univ Arrixaca, Med Oncol Dept, Murcia 30120, Spain
Salgado, M:
Complejo Hosp Ourense, Med Oncol Dept, Orense 32005, Spain
Viudez, A:
Complejo Hosp Navarra, Inst Invest Sanitarias Navarra IdISNA, Med Oncol Dept, Pamplona 31008, Spain
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