RT Journal Article
SR Electronic
T1 Early evaluation using a radiomic signature of unresectable hepatic metastases to predict outcome in patients with colorectal cancer treated with FOLFIRI and bevacizumab
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP 531
OP 539
DO 10.1136/gutjnl-2018-316407
VO 69
IS 3
A1 Anthony Dohan
A1 Benoit Gallix
A1 Boris Guiu
A1 Karine Le Malicot
A1 Caroline Reinhold
A1 Philippe Soyer
A1 Jaafar Bennouna
A1 Francois Ghiringhelli
A1 Emilie Barbier
A1 Valérie Boige
A1 Julien Taieb
A1 Olivier Bouché
A1 Eric François
A1 Jean-Marc Phelip
A1 Christian Borel
A1 Roger Faroux
A1 Jean-Francois Seitz
A1 Stéphane Jacquot
A1 Meher Ben Abdelghani
A1 Faiza Khemissa-Akouz
A1 Dominique Genet
A1 Jean Louis Jouve
A1 Yves Rinaldi
A1 Françoise Desseigne
A1 Patrick Texereau
A1 Etienne Suc
A1 Come Lepage
A1 Thomas Aparicio
A1 Christine Hoeffel
A1 ,
YR 2020
UL http://gut.bmj.com/content/69/3/531.abstract
AB Purpose The objective of this study was to build and validate a radiomic signature to predict early a poor outcome using baseline and 2-month evaluation CT and to compare it to the RECIST1·1 and morphological criteria defined by changes in homogeneity and borders.Methods This study is an ancillary study from the PRODIGE-9 multicentre prospective study for which 491 patients with metastatic colorectal cancer (mCRC) treated by 5-fluorouracil, leucovorin and irinotecan (FOLFIRI) and bevacizumab had been analysed. In 230 patients, computed texture analysis was performed on the dominant liver lesion (DLL) at baseline and 2 months after chemotherapy. RECIST1·1 evaluation was performed at 6 months. A radiomic signature (Survival PrEdiction in patients treated by FOLFIRI and bevacizumab for mCRC using contrast-enhanced CT TextuRe Analysis (SPECTRA) Score) combining the significant predictive features was built using multivariable Cox analysis in 120 patients, then locked, and validated in 110 patients. Overall survival (OS) was estimated with the Kaplan-Meier method and compared between groups with the logrank test. An external validation was performed in another cohort of 40 patients from the PRODIGE 20 Trial.Results In the training cohort, the significant predictive features for OS were: decrease in sum of the target liver lesions (STL), (adjusted hasard-ratio(aHR)=13·7, p=1·93×10–7), decrease in kurtosis (ssf=4) (aHR=1·08, p=0·001) and high baseline density of DLL, (aHR=0·98, p<0·001). Patients with a SPECTRA Score >0·02 had a lower OS in the training cohort (p<0·0001), in the validation cohort (p<0·0008) and in the external validation cohort (p=0·0027). SPECTRA Score at 2 months had the same prognostic value as RECIST at 6 months, while non-response according to RECIST1·1 at 2 months was not associated with a lower OS in the validation cohort (p=0·238). Morphological response was not associated with OS (p=0·41).Conclusion A radiomic signature (combining decrease in STL, density and computed texture analysis of the DLL) at baseline and 2-month CT was able to predict OS, and identify good responders better than RECIST1.1 criteria in patients with mCRC treated by FOLFIRI and bevacizumab as a first-line treatment. This tool should now be validated by further prospective studies.Trial registration Clinicaltrial.gov identifier of the PRODIGE 9 study: NCT00952029.Clinicaltrial.gov identifier of the PRODIGE 20 study: NCT01900717.