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    Tumour growth rate as a validated early radiological biomarker able to reflect treatment-induced changes in neuroendocrine tumours; the GREPONET-2 study

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    Authors
    Lamarca, Angela
    Ronot, M
    Moalla, S
    Crona, J
    Opalinska, M
    Lopez, LC
    Pezzutti, D
    Najran, Pavan
    Carvalho, LFDP
    Bezerra, ROF
    Borg, Philip
    Vietti, VN
    Vidal, TH
    de Mestier, L
    Schaefer, N
    Baudin, E
    Sundin, A
    Costa, FP
    Pavel, M
    Dromain, C
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    Affiliation
    Medical Oncology, The Christie NHS Foundation Trust, Manchester
    Issue Date
    2019
    
    Metadata
    Show full item record
    Abstract
    PURPOSE: 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.
    Citation
    Lamarca 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.
    Journal
    Clinical Cancer Research
    URI
    http://hdl.handle.net/10541/622108
    DOI
    10.1158/1078-0432.CCR-19-0963
    PubMed ID
    31375514
    Additional Links
    https://dx.doi.org/10.1158/1078-0432.CCR-19-0963
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1158/1078-0432.CCR-19-0963
    Scopus Count
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