Publication: Evaluating radiological response in pancreatic neuroendocrine tumours treated with sunitinib: comparison of Choi versus RECIST criteria (CRIPNET_ GETNE1504 study).
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Date
2019-09-03
Authors
Solis-Hernandez, Mª Pilar
Fernandez Del Valle, Ana
Carmona-Bayonas, Alberto
Garcia-Carbonero, Rocio
Custodio, Ana
Benavent, Marta
Alonso Gordoa, Teresa
Nuñez-Valdovino, Bárbara
Sanchez Canovas, Manuel
Matos, Ignacio
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Abstract
The purpose of our study was to analyse the usefulness of Choi criteria versus RECIST in patients with pancreatic neuroendocrine tumours (PanNETs) treated with sunitinib. A multicentre, prospective study was conducted in 10 Spanish centres. Computed tomographies, at least every 6 months, were centrally evaluated until tumour progression. One hundred and seven patients were included. Median progression-free survival (PFS) by RECIST and Choi were 11.42 (95% confidence interval [CI], 9.7-15.9) and 15.8 months (95% CI, 13.9-25.7). PFS by Choi (Kendall's τ = 0.72) exhibited greater correlation with overall survival (OS) than PFS by RECIST (Kendall's τ = 0.43). RECIST incorrectly estimated prognosis in 49.6%. Partial response rate increased from 12.8% to 47.4% with Choi criteria. Twenty-four percent of patients with progressive disease according to Choi had stable disease as per RECIST, overestimating treatment effect. Choi criteria predicted PFS/OS. Changes in attenuation occurred early and accounted for 21% of the variations in tumour volume. Attenuation and tumour growth rate (TGR) were associated with improved survival. Choi criteria were able to capture sunitinib's activity in a clinically significant manner better than RECIST; their implementation in standard clinical practice shall be strongly considered in PanNET patients treated with this drug.
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MeSH Terms
Adult
Aged
Aged, 80 and over
Antineoplastic Agents
Confidence Intervals
Female
Humans
Male
Middle Aged
Neuroendocrine Tumors
Pancreatic Neoplasms
Progression-Free Survival
Proportional Hazards Models
Prospective Studies
Response Evaluation Criteria in Solid Tumors
Sunitinib
Tomography, X-Ray Computed
Tumor Burden
Young Adult
Aged
Aged, 80 and over
Antineoplastic Agents
Confidence Intervals
Female
Humans
Male
Middle Aged
Neuroendocrine Tumors
Pancreatic Neoplasms
Progression-Free Survival
Proportional Hazards Models
Prospective Studies
Response Evaluation Criteria in Solid Tumors
Sunitinib
Tomography, X-Ray Computed
Tumor Burden
Young Adult