Correlation of RECIST, Computed Tomography Morphological Response, and Pathological Regression in Hepatic Metastasis Secondary to Colorectal Cancer: The AVAMET Study.
Vera, Ruth; Gómez, María Luisa; Ayuso, Juan Ramón; Figueras, Joan; García-Alfonso, Pilar; Martínez, Virginia; Lacasta, Adelaida; Ruiz-Casado, Ana; Safont, María José; Aparicio, Jorge; Campos, Juan Manuel; Cámara, Juan Carlos; Martín-Richard, Marta; Montagut, Clara; Pericay, Carles; Vieitez, Jose María; Falcó, Esther; Jorge Fernández, Monica; Marín, Miguel; Salgado Fernández, Mercedes; Viúdez, Antonio
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Identificadores
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Fecha de publicación
2020Título de revista
Cancers (Basel)
Tipo de contenido
Journal Article
Resumen
Background: The prospective phase IV AVAMET study was undertaken to correlate response evaluation criteria in solid tumors (RECIST)-defined response rates with computed tomography-based morphological criteria (CTMC) and pathological response after liver resection of colorectal cancer metastases. Methods: Eligible patients were aged >/=18 years, with Eastern Cooperative Oncology Group (ECOG) performance status 0/1 and histologically-confirmed colon or rectal adenocarcinoma with measurable liver metastases. Preoperative treatment was bevacizumab (7.5 mg on day 1) + XELOX (oxaliplatin 130 mg/m(2), capecitabine 1000 mg/m(2) bid on days 1-14 q3w). After three cycles, response was evaluated by a multidisciplinary team. Patients who were progression-free and metastasectomy candidates received one cycle of XELOX before undergoing surgery 3-5 weeks later, followed by four cycles of bevacizumab + XELOX. Results: A total of 83 patients entered the study; 68 were eligible for RECIST, 67 for CTMC, and 51 for pathological response evaluation. Of these patients, 49% had a complete or partial RECIST response, 91% had an optimal or incomplete CTMC response, and 81% had a complete or major pathological response. CTMC response predicted 37 of 41 pathological responses versus 23 of 41 responses predicted using RECIST (p = 0.008). Kappa coefficients indicated a lack of correlation between the results of RECIST and morphological responses and between morphological and pathological response rates. Conclusion: CTMC may represent a better marker of pathological response to bevacizumab + XELOX than RECIST in patients with potentially-resectable CRC liver metastases.