Erwin Woff1, Pashalina Kehagias2, Caroline Vandeputte2, Lieveke Ameye3, Thomas Guiot1, Marianne Paesmans3, Alain Hendlisz4, Patrick Flamen5. 1. Nuclear Medicine Department, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium. 2. Gastro-Oncology Translational Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium. 3. Data Centre, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium; and. 4. Medical Oncology Department, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium. 5. Nuclear Medicine Department, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium patrick.flamen@bordet.be.
Abstract
Baseline whole-body metabolically active tumor volume (WB-MATV) measured by 18F-FDG PET/CT and circulating cell-free DNA (cfDNA) have been separately validated as predictors of overall and progression-free survival (OS/PFS) in chemorefractory metastatic colorectal cancer (mCRC) patients. This study assessed the correlation between WB-MATV and cfDNA, evaluating the added prognostic value of these in combination, along with clinical parameters. Methods: Of 141 mCRC patients included in a prospective multicenter trial, 132 were evaluable for OS/PFS. cfDNA was extracted from 3 mL of plasma and quantified using a fluorometer. All target lesions were delineated on 18F-FDG PET/CT, and their metabolic volumes were summed to obtain the WB-MATV. Results: Baseline WB-MATV and cfDNA were strongly correlated (r = 0.70; P < 0.001) but showed discordance in 23 of 132 (17%) patients. A multivariate analysis identified 3 independent negative predictors of PFS (high cfDNA, short time since diagnosis, and body mass index < 30) and 5 of OS (high cfDNA, high WB-MATV, body mass index < 30, poor performance status, and short time since diagnosis). Combining WB-MATV and cfDNA increased the overall prognostic value and allowed identification of a subgroup of patients with low cfDNA and high WB-MATV who were associated with intermediate survival (median OS of 8.1 for low-cfDNA/high-MATV patients vs. 12.7 mo for low-cfDNA/low-MATV patients; hazard ratio, 2.04; P = 0.02). Conclusion: This study confirms the added prognostic value of combined circulating cfDNA and PET-based WB-MATV in chemorefractory mCRC patients. The combination of these two biomarkers should provide a firm basis for risk stratification, both in clinical practice and in research trials.
Baseline whole-body metabolically active tumor volume (WB-MATV) measured by 18F-FDG PET/CT and circulating cell-free DNA (cfDNA) have been separately validated as predictors of overall and progression-free survival (OS/PFS) in chemorefractory metastatic colorectal cancer (mCRC) patients. This study assessed the correlation between WB-MATV and cfDNA, evaluating the added prognostic value of these in combination, along with clinical parameters. Methods: Of 141 mCRC patients included in a prospective multicenter trial, 132 were evaluable for OS/PFS. cfDNA was extracted from 3 mL of plasma and quantified using a fluorometer. All target lesions were delineated on 18F-FDG PET/CT, and their metabolic volumes were summed to obtain the WB-MATV. Results: Baseline WB-MATV and cfDNA were strongly correlated (r = 0.70; P < 0.001) but showed discordance in 23 of 132 (17%) patients. A multivariate analysis identified 3 independent negative predictors of PFS (high cfDNA, short time since diagnosis, and body mass index < 30) and 5 of OS (high cfDNA, high WB-MATV, body mass index < 30, poor performance status, and short time since diagnosis). Combining WB-MATV and cfDNA increased the overall prognostic value and allowed identification of a subgroup of patients with low cfDNA and high WB-MATV who were associated with intermediate survival (median OS of 8.1 for low-cfDNA/high-MATVpatients vs. 12.7 mo for low-cfDNA/low-MATVpatients; hazard ratio, 2.04; P = 0.02). Conclusion: This study confirms the added prognostic value of combined circulating cfDNA and PET-based WB-MATV in chemorefractory mCRC patients. The combination of these two biomarkers should provide a firm basis for risk stratification, both in clinical practice and in research trials.
Authors: J M González de Aledo-Castillo; S Casanueva-Eliceiry; A Soler-Perromat; D Fuster; V Pastor; N Reguart; N Viñolas; R Reyes; I Vollmer; P Paredes; J A Puig-Butillé Journal: Eur J Nucl Med Mol Imaging Date: 2021-04-02 Impact factor: 9.236
Authors: Natalia O Tuaeva; Luca Falzone; Yuri B Porozov; Alexander E Nosyrev; Vladimir M Trukhan; Leda Kovatsi; Demetrios A Spandidos; Nikolaos Drakoulis; Alexandra Kalogeraki; Charalampos Mamoulakis; George Tzanakakis; Massimo Libra; Aristides Tsatsakis Journal: Cells Date: 2019-10-14 Impact factor: 6.600