Tumour growth rate as a validated early radiological biomarker able to reflect treatment-induced changes in neuroendocrine tumours; the GREPONET-2 study
de Mestier, L
AffiliationMedical Oncology, The Christie NHS Foundation Trust, Manchester
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AbstractPURPOSE: TGR represents the percentage change in tumour volume per month (%/m). Previous results from the GREPONET study showed that TGR measured after 3 months (TGR3m) of starting systemic treatment (ST) or watch and wait (WW) was an early biomarker predicting progression-free survival (PFS) in NETs. EXPERIMENTAL DESIGN: Pts from7 centres with advanced grade(G) 1/2 NETs from the pancreas(P)/small bowel(SB) initiating ST/WW were eligible. Computed tomography (CT) / magnetic resonance imaging (MRI) performed at pre-baseline, baseline and 3(+/-1) months of study entry were retrospectively reviewed. Aim-1: explore treatment-induced changes in TGR (?TGR3m-BL) (paired T-test) and Aim-2: validate TGR3m (<0.8%/m vs ?0.8%/m) as an early biomarker in an independent cohort (Kaplan-Meier/Cox Regression). RESULTS: Out of 785 pts screened, 127 were eligible. Mean (SD) TGR0 and TGR3m were 5.4%/m (14.9) and -1.4%/m (11.8), respectively. Mean(SD) ?TGR3m-BL paired-difference was -6.8%/m(19.3) (p<0.001). Most marked ?TGR3m-BL (mean (SD);p) were identified with targeted therapies (-11.3%/m(4.7);0.0237) and chemotherapy (-7.9%/m(3.4);0.0261). Multivariable analysis confirmed the absence of previous treatment (Odds Ratio (OR) 4.65 (95%CI 1.31-16.52); p-value0.018) and low TGR3m (continuous variable; OR 1.09 (95%CI 1.01-1.19); p-value0.042) to be independent predictors of radiological objective response. When the multivariable Cox Regression was adjusted to grade (p-value 0.004) and stage (p-value0.017), TGR3m?0.8 (vs.<0.8) maintained its significance (p<0.001), while TGR0 and ?TGR3m-BL did not. TGR3m was confirmed as an independent prognosis factor for PFS (external validation; Aim-2) (multivariable HR 2.21 (95%CI 1.21-3.70); p-value0.003). CONCLUSIONS: TGR has a role as biomarker for monitoring response to therapy for early prediction of PFS and radiological objective response.
CitationLamarca A, Ronot M, Moalla S, Crona J, Opalinska M, Lopez Lopez C, et al. Tumour growth rate as a validated early radiological biomarker able to reflect treatment-induced changes in neuroendocrine tumours; the GREPONET-2 study. Clin Cancer Res. 2019 Aug 2.
JournalClinical Cancer Research
- Value of Tumor Growth Rate (TGR) as an Early Biomarker Predictor of Patients' Outcome in Neuroendocrine Tumors (NET)-The GREPONET Study.
- Authors: Lamarca A, Crona J, Ronot M, Opalinska M, Lopez Lopez C, Pezzutti D, Najran P, Carvhalo L, Franca Bezerra RO, Borg P, Vietti Violi N, Vidal Trueba H, de Mestier L, Schaefer N, Sundin A, Costa F, Pavel M, Dromain C, Knowledge Network.
- Issue date: 2019 Nov
- Tumour Growth Rate to predict the outcome of patients with Neuroendocrine Tumours: Performance and sources of variability.
- Authors: Dromain C, Sundin A, Najran P, Vidal Trueba H, Dioguardi Burgio M, Crona J, Opalinska M, Carvalho L, Franca R, Borg P, Vietti Violi N, Schaefer N, Lopez C, Pezzutti D, de Mestier L, Lamarca A, Costa F, Pavel M, Ronot M
- Issue date: 2020 Jul 27
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- Issue date: 2019 Jan 14
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- Authors: Cheng SH, Cheng YJ, Jin ZY, Xue HD
- Issue date: 2019 Apr