Dynamic contrast-enhanced magnetic resonance imaging biomarkers predict survival and response in hepatocellular carcinoma patients treated with sorafenib and metronomic tegafur/uracil
Journal
Journal of Hepatology
Journal Volume
55
Journal Issue
4
Pages
858-865
Date Issued
2011
Author(s)
Abstract
Background & Aims: Sorafenib plus metronomic tegafur/uracil therapy can induce tumor stabilization in advanced hepatocellular carcinoma (HCC) patients. This study evaluated the correlation of vascular response measured by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and the clinical outcome. Methods: DCE-MRI was performed in advanced HCC patients treated with sorafenib (800 mg/d) plus tegafur/uracil (250 mg/m 2/d based on tegafur) at baseline and after 14 days of treatment. An operator-defined region of interest was placed in the most strongly enhanced area of the tumor to measure the pharmacokinetic parameter K trans. Changes in K trans after treatment were correlated with the best tumor response and survival. Results: Thirty-one patients were evaluable. There were one partial response (PR), 18 stable disease (SD), and 12 progressive disease (PD) according to the Response Evaluation Criteria in Solid Tumors (RECIST). Baseline K trans was higher in patients with PR or SD (median 1215.2 × 10 -3/min, range 582.5-4555.3 × 10 -3/min) than patients with PD (median 702.0 × 10 -3/min, range 375.2-1938.0 × 10 -3/min, p = 0.008). After 14 days of study treatment, the median K trans change was -47.1% (range -87.0 to -18.0%) in patients with PR or SD, and 9.6% (range -44.8 to +81%) in those with PD (p <0.001). A vascular response, defined by a 40% or greater decrease in K trans after 14 days of study treatment, correlated with longer progression-free survival (median 29.1 vs. 8.7 weeks, p = 0.033) and overall survival (median 53.0 vs. 14.9 weeks, p = 0.016). Percentage of K trans change after treatment is an independent predictor of tumor response, progression-free survival, and overall survival. Conclusions: K trans measured by DCE-MRI correlated well with tumor response and survival in HCC patients who received sorafenib plus metronomic tegafur/uracil therapy. ? 2011 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
SDGs
Other Subjects
sorafenib; UFT; adult; aged; article; blood vessel reactivity; cancer survival; clinical article; dynamic contrast enhanced magnetic resonance imaging; female; human; liver cell carcinoma; male; nuclear magnetic resonance imaging; outcome assessment; overall survival; phase 2 clinical trial (topic); priority journal; progression free survival; survival rate; survival time; treatment response; Adult; Aged; Aged, 80 and over; Antimetabolites, Antineoplastic; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Benzenesulfonates; Biological Markers; Carcinoma, Hepatocellular; Contrast Media; Feasibility Studies; Female; Humans; Liver Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Neovascularization, Pathologic; Predictive Value of Tests; Pyridines; Tegafur; Uracil; Young Adult
Type
journal article