학술논문
Correlation of RECIST, Computed Tomography Morphological Response, and Pathological Regression in Hepatic Metastasis Secondary to Colorectal Cancer: The AVAMET Study.
Document Type
Academic Journal
Author
Vera R; Medical Oncology Department, Complejo Hospitalario de Navarra, Instituto de investigaciones Sanitarias de Navarra (IdISNA), 31008 Pamplona, Spain.; Gómez ML; Pathology Department, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain.; Ayuso JR; Radiology Department, Hospital Clínic de Barcelona, 08036 Barcelona, Spain.; Figueras J; General and digestive surgery Department, Hospital Universitario Josep Trueta, 17007 Girona, Spain.; García-Alfonso P; Medical Oncology Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain.; Martínez V; Medical Oncology Department, Hospital Universitario La Paz, 28046 Madrid, Spain.; Lacasta A; Medical Oncology Department, Hospital Universitario Donostia, 20014 San Sebastian, Spain.; Ruiz-Casado A; Medical Oncology Department, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Spain.; Safont MJ; Medical Oncology Department, Hospital General Universitario de Valencia, 46014 Valencia, Spain.; Aparicio J; Medical Oncology Department, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain.; Campos JM; Medical Oncology Department, Hospital Arnau de Vilanova, 46015 Valencia, Spain.; Cámara JC; Medical Oncology Department, Hospital Universitario Fundación Alcorcón, 28922 Madrid, Spain.; Martín-Richard M; Medical Oncology Department, Hospital la Santa Creu i Sant Pau, 08041 Barcelona, Spain.; Montagut C; Medical Oncology Department, Hospital de Mar, 08003 Barcelona, Spain.; Pericay C; Medical Oncology Department, C.S. Parc Taulí, 08208 Sabadell, Spain.; Vieitez JM; Medical Oncology Department, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.; Falcó E; Medical Oncology Department, Hospital Universitario Son Llàtzer, 07198 Palma de Mallorca, Spain.; Jorge M; Medical Oncology Department, Hospital Xeral Cíes, 36204 Vigo, Spain.; Marín M; Medical Oncology Department, Hospital Clínico Universitario de la Arrixaca, 30120 Murcia, Spain.; Salgado M; Medical Oncology Department, Complejo Hospitalario de Ourense, 32005 Ourense, Spain.; Viúdez A; Medical Oncology Department, Complejo Hospitalario de Navarra, Instituto de investigaciones Sanitarias de Navarra (IdISNA), 31008 Pamplona, Spain.
Source
Publisher: MDPI Country of Publication: Switzerland NLM ID: 101526829 Publication Model: Electronic Cited Medium: Print ISSN: 2072-6694 (Print) Linking ISSN: 20726694 NLM ISO Abbreviation: Cancers (Basel) Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2072-6694
Abstract
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.