Prospective evaluation of quantitative response parameter in patients with Gastrointestinal Stroma Tumor undergoing tyrosine kinase inhibitor therapy

• Verfasst von: Meyer, Mathias [VerfasserIn]
• Verfasst von: Ota, Hideki [VerfasserIn]
• Verfasst von: Messiou, Christina [VerfasserIn]
• Verfasst von: Benson, Charlotte [VerfasserIn]
• Verfasst von: Henzler, Thomas [VerfasserIn]
• Verfasst von: Mattonen, Sarah A. [VerfasserIn]
• Verfasst von: Marin, Daniele [VerfasserIn]
• Verfasst von: Bartsch, Anna [VerfasserIn]
• Verfasst von: Schönberg, Stefan [VerfasserIn]
• Verfasst von: Riedel, Richard F. [VerfasserIn]
• Verfasst von: Hohenberger, Peter [VerfasserIn]
• Titel: Prospective evaluation of quantitative response parameter in patients with Gastrointestinal Stroma Tumor undergoing tyrosine kinase inhibitor therapy
• Titelzusatz: impact on clinical outcome : cancer therapy and prevention
• Verf.angabe: Mathias Meyer, Hideki Ota, Christina Messiou, Charlotte Benson, Thomas Henzler, Sarah A. Mattonen, Daniele Marin, Anna Bartsch, Stefan O. Schoenberg, Richard F. Riedel, Peter Hohenberger
• E-Jahr: 2024
• Jahr: 1 December 2024
• Umfang: 11 S.
• Fussnoten: Erstmals veröffentlicht: 18. Juli 2024 ; Gesehen am 18.11.2024
• Titel Quelle: Enthalten in: International journal of cancer
• Ort Quelle: Bognor Regis : Wiley-Liss, 1966
• Jahr Quelle: 2024
• Band/Heft Quelle: 155(2024), 11 vom: Dez., Seite 2047-2057
• ISSN Quelle: 1097-0215
• DOI: doi:10.1002/ijc.35094
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: gastrointestinal stromal tumor
• Sach-SW: imaging biomarker
• Sach-SW: response assessment
• Sach-SW: spectral CT
• K10plus-PPN: 1908884711

Abstract

The purpose of this study was to determine if dual-energy CT (DECT) vital iodine tumor burden (ViTB), a direct assessment of tumor vascularity, allows reliable response assessment in patients with GIST compared to established CT criteria such as RECIST1.1 and modified Choi (mChoi). From 03/2014 to 12/2019, 138 patients (64 years [32-94 years]) with biopsy proven GIST were entered in this prospective, multi-center trial. All patients were treated with tyrosine kinase inhibitors (TKI) and underwent pre-treatment and follow-up DECT examinations for a minimum of 24 months. Response assessment was performed according to RECIST1.1, mChoi, vascular tumor burden (VTB) and DECT ViTB. A change in therapy management could be because of imaging (RECIST1.1 or mChoi) and/or clinical progression. The DECT ViTB criteria had the highest discrimination ability for progression-free survival (PFS) of all criteria in both first line and second line and thereafter treatment, and was significantly superior to RECIST1.1 and mChoi (p < .034). Both, the mChoi and DECT ViTB criteria demonstrated a significantly early median time-to-progression (both delta 2.5 months; both p < .036). Multivariable analysis revealed 6 variables associated with shorter overall survival: secondary mutation (HR = 4.62), polymetastatic disease (HR = 3.02), metastatic second line and thereafter treatment (HR = 2.33), shorter PFS determined by the DECT ViTB criteria (HR = 1.72), multiple organ metastases (HR = 1.51) and lower age (HR = 1.04). DECT ViTB is a reliable response criteria and provides additional value for assessing TKI treatment in GIST patients. A significant superior response discrimination ability for median PFS was observed, including non-responders at first follow-up and patients developing resistance while on therapy.