Positron Emission Tomography/Computed Tomography and Biomarkers for Early Treatment Response Evaluation in Metastatic Colon Cancer
Background. Treatment options for metastatic colon cancer (mCC) are widening. We prospectively evaluated serial 2‐deoxy‐2‐[18F]fluoro‐ d‐glucose positron‐emission tomography/computed tomography (PET/CT) and measurements of tissue inhibitor of metalloproteinases‐1 (TIMP‐1), carcinoembryonic antigen (CEA), and liberated domain I of urokinase plasminogen activator receptor (uPAR(I)) for early assessment of treatment response in mCC patients. Methods. Thirty‐three mCC patients scheduled for first‐line chemotherapy with capecitabine and oxaliplatin (CAPOX) and bevacizumab participated; 27 were evaluated by PET/CT before treatment, after one and four treatment series. Morphological and metabolic response was independently assessed according to Response Evaluation Criteria in Solid Tumors and European Organization for Research and Treatment of Cancer PET criteria. Plasma TIMP‐1, plasma uPAR(I), and serum CEA were determined. Results. Metabolic response after one treatment course predicted the ability of CAPOX and bevacizumab to induce morphological response after four treatment series with a sensitivity of 80%, specificity of 69%, and odds ratio of 13.9 (95% confidence interval [CI] 1.9; 182). Early metabolically stable or progressive disease was associated with shorter progression‐free survival (hazard ratio [HR] = 3.2 [CI 1.3; 7.8]). Biomarker levels at early evaluation were associated with shorter OS (TIMP‐1 per unit increase on a log‐2‐transformed ng/mL scale: HR = 2.6 [CI 1.4; 4.9]; uPAR(I) per 25 fmol/mL increase: HR = 1.5 [CI 1.1; 2.1]). Conclusion. This monocentric study demonstrated predictive value of early metabolic PET response and prognostic value of TIMP‐1 and uPAR(I) levels in mCC treated with CAPOX and bevacizumab. Results support investigation of PET/CT, TIMP‐1, and uPAR(I) guided early treatment adaptation in mCC.摘要背景.转移性结肠癌 (mCC) 的治疗选择日益增多。本文在 mCC 患者治疗反应的早期评估方面，前瞻性评价了 2‐脱氧‐2‐[18F]氟‐D‐葡萄糖正电子发射断层造影术/计算机断层扫描 (PET/CT) 系列应用和金属蛋白酶‐1 组织抑制剂 (TIMP‐1)、癌胚抗原 (CEA)、以及尿激酶型纤溶酶原激活物受体的自由域 (uPAR(I)) 的检测。方法.参与研究的有给与卡培他滨、奥沙利铂 (CAPOX) 和贝伐单抗一线化疗的33 名患者； 其中27 名在治疗前、治疗一个系列和四个系列后，采用 PET/CT 评估。根据实体瘤的疗效评价标准和欧洲癌症研究与治疗组织 PET 标准，分别单独进行形态学和代谢水平两方面的反应评估。测定血浆中 TIMP‐1 和 uPAR(I) 的浓度以及 CEA 血清水平。结果.根据一个疗程后的代谢反应，可以推测 CAPOX 和贝伐单抗在四个治疗系列后产生形态学反应的疗效作用，其灵敏度为 80%、特异性为 69% 、比值比为 13.9（95% 置信区间 [CI 1.9; 182]）。早期代谢稳定或疾病进展者的无进展存活期较短（风险比 [HR] = 3.2 [CI 1.3; 7.8]）。早期评价的生物标记物水平与较短的整体存活期 (OS) (ng/mL 量级 log2 对数转换后的 TIMP‐1 每单位增量：HR=2.6 [CI 1.4; 4.9]; uPAR(I) 每 25 fmol/mL 增量：HR = 1.5 [CI 1.1; 2.1]) 有关。结论.本单中心研究证实，在接受 CAPOX 与贝伐单抗治疗的 mCC 患者中，早期代谢性 PET 反应具有预测价值，TIMP‐1 的 uPAR(I) 具有预后价值。结果支持，检测 PET/CT、TIMP‐1 以及 uPAR (I) 对 mCC 患者的早期治疗适应有指导作用。 The Oncologist2014;19:1‐9.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2014 |
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| Erschienen: |
2014 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:19 |
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| Enthalten in: |
The oncologist - 19(2014), 2, Seite 164-172 |
| Beteiligte Personen: |
Engelmann, Bodil E. [VerfasserIn] |
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| Anmerkungen: |
© AlphaMed Press |
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| Umfang: |
9 |
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| doi: |
10.1634/theoncologist.2013-0229 |
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| Förderinstitution / Projekttitel: |
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WLY011906324 |
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| 520 | |a Background. Treatment options for metastatic colon cancer (mCC) are widening. We prospectively evaluated serial 2‐deoxy‐2‐[18F]fluoro‐ d‐glucose positron‐emission tomography/computed tomography (PET/CT) and measurements of tissue inhibitor of metalloproteinases‐1 (TIMP‐1), carcinoembryonic antigen (CEA), and liberated domain I of urokinase plasminogen activator receptor (uPAR(I)) for early assessment of treatment response in mCC patients. Methods. Thirty‐three mCC patients scheduled for first‐line chemotherapy with capecitabine and oxaliplatin (CAPOX) and bevacizumab participated; 27 were evaluated by PET/CT before treatment, after one and four treatment series. Morphological and metabolic response was independently assessed according to Response Evaluation Criteria in Solid Tumors and European Organization for Research and Treatment of Cancer PET criteria. Plasma TIMP‐1, plasma uPAR(I), and serum CEA were determined. Results. Metabolic response after one treatment course predicted the ability of CAPOX and bevacizumab to induce morphological response after four treatment series with a sensitivity of 80%, specificity of 69%, and odds ratio of 13.9 (95% confidence interval [CI] 1.9; 182). Early metabolically stable or progressive disease was associated with shorter progression‐free survival (hazard ratio [HR] = 3.2 [CI 1.3; 7.8]). Biomarker levels at early evaluation were associated with shorter OS (TIMP‐1 per unit increase on a log‐2‐transformed ng/mL scale: HR = 2.6 [CI 1.4; 4.9]; uPAR(I) per 25 fmol/mL increase: HR = 1.5 [CI 1.1; 2.1]). Conclusion. This monocentric study demonstrated predictive value of early metabolic PET response and prognostic value of TIMP‐1 and uPAR(I) levels in mCC treated with CAPOX and bevacizumab. Results support investigation of PET/CT, TIMP‐1, and uPAR(I) guided early treatment adaptation in mCC.摘要背景.转移性结肠癌 (mCC) 的治疗选择日益增多。本文在 mCC 患者治疗反应的早期评估方面，前瞻性评价了 2‐脱氧‐2‐[18F]氟‐D‐葡萄糖正电子发射断层造影术/计算机断层扫描 (PET/CT) 系列应用和金属蛋白酶‐1 组织抑制剂 (TIMP‐1)、癌胚抗原 (CEA)、以及尿激酶型纤溶酶原激活物受体的自由域 (uPAR(I)) 的检测。方法.参与研究的有给与卡培他滨、奥沙利铂 (CAPOX) 和贝伐单抗一线化疗的33 名患者； 其中27 名在治疗前、治疗一个系列和四个系列后，采用 PET/CT 评估。根据实体瘤的疗效评价标准和欧洲癌症研究与治疗组织 PET 标准，分别单独进行形态学和代谢水平两方面的反应评估。测定血浆中 TIMP‐1 和 uPAR(I) 的浓度以及 CEA 血清水平。结果.根据一个疗程后的代谢反应，可以推测 CAPOX 和贝伐单抗在四个治疗系列后产生形态学反应的疗效作用，其灵敏度为 80%、特异性为 69% 、比值比为 13.9（95% 置信区间 [CI 1.9; 182]）。早期代谢稳定或疾病进展者的无进展存活期较短（风险比 [HR] = 3.2 [CI 1.3; 7.8]）。早期评价的生物标记物水平与较短的整体存活期 (OS) (ng/mL 量级 log2 对数转换后的 TIMP‐1 每单位增量：HR=2.6 [CI 1.4; 4.9]; uPAR(I) 每 25 fmol/mL 增量：HR = 1.5 [CI 1.1; 2.1]) 有关。结论.本单中心研究证实，在接受 CAPOX 与贝伐单抗治疗的 mCC 患者中，早期代谢性 PET 反应具有预测价值，TIMP‐1 的 uPAR(I) 具有预后价值。结果支持，检测 PET/CT、TIMP‐1 以及 uPAR (I) 对 mCC 患者的早期治疗适应有指导作用。 The Oncologist2014;19:1‐9 | ||
| 700 | 1 | |a Loft, Annika |4 aut | |
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| 700 | 1 | |a Brünner, Nils |4 aut | |
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