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Prospective evaluation of quantitative response parameter in patients with Gastrointestinal Stroma Tumor undergoing tyrosine kinase inhibitor therapy: impact on clinical outcome : cancer therapy and prevention

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 1...

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Main Authors: Meyer, Mathias (Author) , Ota, Hideki (Author) , Messiou, Christina (Author) , Benson, Charlotte (Author) , Henzler, Thomas (Author) , Mattonen, Sarah A. (Author) , Marin, Daniele (Author) , Bartsch, Anna (Author) , Schönberg, Stefan (Author) , Riedel, Richard F. (Author) , Hohenberger, Peter (Author)
Format: Article (Journal)
Language:English
Published: 1 December 2024
In: International journal of cancer
Year: 2024, Volume: 155, Issue: 11, Pages: 2047-2057
ISSN:1097-0215
DOI:10.1002/ijc.35094
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1002/ijc.35094
Verlag, kostenfrei, Volltext: http://onlinelibrary.wiley.com/doi/abs/10.1002/ijc.35094
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Author Notes: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
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Summary: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.
Item Description:Erstmals veröffentlicht: 18. Juli 2024
Gesehen am 18.11.2024
Physical Description:Online Resource
ISSN:1097-0215
DOI:10.1002/ijc.35094

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