Tumor Growth Rate as a Validated Early Radiological Biomarker Able to Reflect Treatment-Induced Changes in Neuroendocrine Tumors: The GREPONET-2 Study.

Details

Serval ID
serval:BIB_9AC787A38DB8
Type
Article: article from journal or magazin.
Collection
Publications
Title
Tumor Growth Rate as a Validated Early Radiological Biomarker Able to Reflect Treatment-Induced Changes in Neuroendocrine Tumors: The GREPONET-2 Study.
Journal
Clinical cancer research
Author(s)
Lamarca A., Ronot M., Moalla S., Crona J., Opalinska M., Lopez Lopez C., Pezzutti D., Najran P., Carvhalo L., Bezerra ROF, Borg P., Vietti Violi N., Vidal Trueba H., de Mestier L., Scaefer N., Baudin E., Sundin A., Costa F., Pavel M., Dromain C.
ISSN
1078-0432 (Print)
ISSN-L
1078-0432
Publication state
Published
Issued date
15/11/2019
Peer-reviewed
Oui
Volume
25
Number
22
Pages
6692-6699
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Tumor growth rate (TGR) represents the percentage change in tumor volume per month (%/m). Previous results from the GREPONET study showed that TGR measured after 3 months (TGR <sub>3m</sub> ) of starting systemic treatment (ST) or watch and wait (WW) was an early biomarker predicting progression-free survival (PFS) in neuroendocrine tumors (NET).
Patients from 7 centers with advanced grade (G) 1/2 NETs from the pancreas (P)/small bowel (SB) initiating ST/WW were eligible. Computed tomography (CT)/MRI performed at prebaseline, baseline, and 3(±1) months of study entry were retrospectively reviewed. Aim-1: explore treatment-induced changes in TGR (ΔTGR <sub>3m-BL</sub> ; paired T test), and Aim-2: validate TGR <sub>3m</sub> (<0.8%/m vs. ≥0.8%/m) as an early biomarker in an independent cohort (Kaplan-Meier/Cox regression).
Of 785 patients screened, 127 were eligible. Mean (SD) TGR <sub>0</sub> and TGR <sub>3m</sub> were 5.4%/m (14.9) and -1.4%/m (11.8), respectively. Mean (SD) ΔTGR <sub>3m-BL</sub> paired-difference was -6.8%/m (19.3; P < 0.001). Most marked ΔTGR <sub>3m-BL</sub> [mean (SD)] were identified with targeted therapies [-11.3%/m (4.7); P = 0.0237] and chemotherapy [-7.9%/m (3.4); P = 0.0261]. Multivariable analysis confirmed the absence of previous treatment (OR = 4.65; 95% CI, 1.31-16.52; P = 0.018) and low TGR <sub>3m</sub> (continuous variable; OR 1.09; 95% CI, 1.01-1.19; P = 0.042) to be independent predictors of radiologic objective response. When the multivariable survival analysis for PFS (Cox regression) was adjusted to grade (P = 0.004) and stage (P = 0.017), TGR <sub>3m</sub> ≥ 0.8 (vs. <0.8) maintained its significance as a prognostic factor (P < 0.001), whereas TGR <sub>0</sub> and ΔTGR <sub>3m-BL</sub> did not. TGR <sub>3m</sub> ≥ 0.8%/m was confirmed as an independent prognostic factor for PFS [external validation; Aim-2; multivariable HR 2.21 (95% CI, 1.21-3.70; P = 0.003)].
TGR has a role as a biomarker for monitoring response to therapy for early identification of treatment-induced changes and for early prediction of PFS and radiologic objective response.
Pubmed
Web of science
Create date
18/08/2019 15:58
Last modification date
06/05/2020 17:08
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