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Ng C , Zhang Z , Lee SI , Marques HS , Burgers K , Su F , Bauza J , Mannel RS , Walker J , Huh WK , Rubin SC , DiSilvestro P , Martin LP , Chan JK , Bookman MA , Coleman RL , Lee TY
CT perfusion as an early biomarker of treatment efficacy in advanced ovarian cancer: an ACRIN and GOG study
Clin Cancer Res. 2017 Jul 15;23(14) :3684-3691
PMID: 28174234    PMCID: PMC5720368    URL: https://www.ncbi.nlm.nih.gov/pubmed/28174234
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Abstract
PURPOSE: ACRIN 6695 was a feasibility study investigating whether CT perfusion (CTP) biomarkers are associated with progression-free survival at 6 months (PFS-6) in patients with advanced ovarian cancer who were treated with carboplatin and either dose-dense (weekly) or conventional (3-weekly) paclitaxel, with optional bevacizumab in the prospective phase III GOG-0262 trial. EXPERIMENTAL DESIGN: ACRIN 6695 recruited participants with residual disease after primary cytoreductive surgery or planned interval cytoreduction following neoadjuvant therapy, to undergo CTP studies before (T0), 3-weeks (T1) and 4-weeks (T2) after chemotherapy initiation. Tumor blood flow (BF) and blood volume (BV) were derived with commercial software. Fisher's exact tests assessed the associations of CTP biomarkers changes from T0 to T2 dichotomized at zero with PFS-6 and overall radiographic response rate, while Cox regression assessed the associations between CTP biomarkers changes and progression-free survival (PFS) and overall survival (OS). Bonferroni correction was used to account for multiple comparisons. RESULTS: 76 of 120 enrolled patients from 19 centers were evaluable with a median age of 61 years. BV increase was significantly associated with lower chance of PFS-6 (p=0.028), while BF achieves borderline significance (p=0.053). In addition, BF increase was associated with shorter PFS (HR 2.9, 95% CI 1.3-6.4, p=0.008) and remained significant after adjusting for age, change in tumor volume and surgery status (p=0.007). Neither BF nor BV changes were significantly associated with treatment response rate or OS. CONCLUSIONS: Early CTP biomarkers measurement may provide early prognostic information for PFS in newly-diagnosed ovarian cancer.
Notes
Ng, Chaan Zhang, Zheng Lee, Susanna I Marques, Helga S Burgers, Kyle Su, Feng Bauza, Joseph Mannel, Robert S Walker, Joan Huh, Warner K Rubin, Stephen C DiSilvestro, Paul Martin, Lainie P Chan, John K Bookman, Michael A Coleman, Robert L Lee, Ting-Yim Journal Article United States Clin Cancer Res. 2017 Feb 7. pii: clincanres.1859.2016. doi: 10.1158/1078-0432.CCR-16-1859.