Correlation of RECIST, Computed Tomography Morphological Response, and Pathological Regression in Hepatic Metastasis Secondary to Colorectal Cancer: The AVAMET Study
Year: 2020
Type: article
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/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.
Source: Cancers
Authors: Ruth Vera, María Luisa Gómez, Juan Ramón Ayuso, Joan Figueras, Pilar García-Alfonso, Virginia Martínez, Adelaida Lacasta, Ana Ruiz-Casado, María José Safont, Jorge Aparicio, Juan Manuel Campos, Juan Carlos Cámara, Marta Martín-Richard, Clara Montagut, Carles Pericay, Jose María Vieitez, Esther Falcó, Mónica Jorge, Miguel Marín, Mercedes Salgado, Antonio Viúdez
Institutions: Complejo Hospitalario de Navarra, Navarre Institute of Health Research, Hospital Clínic de Barcelona, Hospital Universitari de Girona Doctor Josep Trueta, Hospital General Universitario Gregorio Marañón, Hospital Universitario La Paz, Donostiako Unibertsitate Ospitalea, Hospital Universitario Puerta de Hierro Majadahonda, Hospital General Universitario De Valencia, Hospital Universitari i Politècnic La Fe, Hospital Arnau de Vilanova, Hospital Universitario Fundación Alcorcón, Hospital de Sant Pau, Hospital Del Mar, Corporació Sanitària Parc Taulí, Hospital Universitario Central de Asturias, Hospital Son Llatzer, Hospital Universitario Virgen de la Arrixaca, Complejo Hospitalario de Ourense
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,324
OpenAlex ID: W3048745652