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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.

Publication ,  Journal Article
Meyer, M; Ota, H; Messiou, C; Benson, C; Henzler, T; Mattonen, SA; Marin, D; Bartsch, A; Schoenberg, SO; Riedel, RF; Hohenberger, P
Published in: Int J Cancer
December 1, 2024

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.

Duke Scholars

Published In

Int J Cancer

DOI

EISSN

1097-0215

Publication Date

December 1, 2024

Volume

155

Issue

11

Start / End Page

2047 / 2057

Location

United States

Related Subject Headings

  • Tyrosine Kinase Inhibitors
  • Tumor Burden
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Response Evaluation Criteria in Solid Tumors
  • Protein Kinase Inhibitors
  • Prospective Studies
  • Progression-Free Survival
  • Oncology & Carcinogenesis
  • Middle Aged
 

Citation

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Meyer, M., Ota, H., Messiou, C., Benson, C., Henzler, T., Mattonen, S. A., … Hohenberger, P. (2024). Prospective evaluation of quantitative response parameter in patients with Gastrointestinal Stroma Tumor undergoing tyrosine kinase inhibitor therapy-Impact on clinical outcome. Int J Cancer, 155(11), 2047–2057. https://doi.org/10.1002/ijc.35094
Meyer, Mathias, Hideki Ota, Christina Messiou, Charlotte Benson, Thomas Henzler, Sarah A. Mattonen, Daniele Marin, et al. “Prospective evaluation of quantitative response parameter in patients with Gastrointestinal Stroma Tumor undergoing tyrosine kinase inhibitor therapy-Impact on clinical outcome.Int J Cancer 155, no. 11 (December 1, 2024): 2047–57. https://doi.org/10.1002/ijc.35094.
Meyer M, Ota H, Messiou C, Benson C, Henzler T, Mattonen SA, Marin D, Bartsch A, Schoenberg SO, Riedel RF, Hohenberger P. Prospective evaluation of quantitative response parameter in patients with Gastrointestinal Stroma Tumor undergoing tyrosine kinase inhibitor therapy-Impact on clinical outcome. Int J Cancer. 2024 Dec 1;155(11):2047–2057.
Journal cover image

Published In

Int J Cancer

DOI

EISSN

1097-0215

Publication Date

December 1, 2024

Volume

155

Issue

11

Start / End Page

2047 / 2057

Location

United States

Related Subject Headings

  • Tyrosine Kinase Inhibitors
  • Tumor Burden
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Response Evaluation Criteria in Solid Tumors
  • Protein Kinase Inhibitors
  • Prospective Studies
  • Progression-Free Survival
  • Oncology & Carcinogenesis
  • Middle Aged