Julius Chapiro MD, Presenter: Nothing to Disclose

Rafael Duran MD, Abstract Co-Author: Nothing to Disclose

MingDe Lin PhD, Abstract Co-Author: Employee, Koninklijke Philips NV

Ruediger Egbert Schernthaner MD, Abstract Co-Author: Nothing to Disclose

Zhijun Wang MD, Abstract Co-Author: Nothing to Disclose

Jean-Francois H. Geschwind MD, Abstract Co-Author: Consultant, BTG International Ltd Consultant, Bayer AG Consultant, Guerbet SA Consultant, Nordion, Inc Grant, BTG International Ltd Grant, F. Hoffmann-La Roche Ltd Grant, Bayer AG Grant, Koninklijke Philips NV Grant, Nordion, Inc Grant, ContextVision AB Grant, CeloNova BioSciences, Inc Founder, PreScience Labs, LLC CEO, PreScience Labs, LLC

To evaluate the role of imaging biomarkers of tumor response in soft-tissue sarcoma (STS) metastases to the liver treated with conventional transarterial chemoembolization (cTACE).  

This study was a retrospective analysis of 25 patients with STS metastases to the liver treated with cTACE. Each patient underwent contrast-enhanced MRI (ceMRI) within 6 weeks before and after therapy. Tumor response of the largest target lesion was assessed on arterial-phase MRI in each patient using RECIST, modified RECIST and EASL guidelines. In addition, a segmentation-based 3D quantification of the enhancing tumor volume (quantitative [q] EASL) was performed. For each method, patients were classified as responders (R) and non-responders (NR) and evaluated using Kaplan-Meier analysis. Overall survival (OS) and progression-free survival (PFS) of the entire cohort were calculated. Clinical parameters (performance, tumor status, treatment history) were included into a multivariate analysis of Cox proportional hazard ratios (HR). 

A total of 65 procedures (mean, 2.6/patient) were performed. Median OS of the entire cohort was 21.2 months (95% CI, 13.4-28.9) and PFS was 6.3 months (95% CI, 4.45-8.2). No patient was classified as R according to RECIST, while 11 (44%), 12 (48%) and 12 (48%) patients were R according to EASL, mRECIST and qEASL, respectively. Multivariate analysis identified tumor response according to mRECIST and qEASL as reliable predictors of improved patient survival (P=0.019; HR 0.3 [0.1-0.8] and P=0.006; HR 0.2 [0.1-0.6], respectively).  

This study demonstrated the advantages of enhancement-based tumor response assessment over size-based RECIST analysis of STS metastases to the liver and validated qEASL as the most predictive assessment method after cTACE. 

The validation of mRECIST and qEASL as prognostically relevant imaging biomarkers of tumor response might help to identify non-responders sooner for potential re-treatment in this rare disease.

Chapiro, J, Duran, R, Lin, M, Schernthaner, R, Wang, Z, Geschwind, J, Transarterial Chemoembolization in Soft-Tissue Sarcoma Metastases to the Liver – The Use of Imaging Biomarkers as Predictors of Patient Survival.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006709.html