Skip to main content
Top

17-06-2024 | Cetuximab | Short Communication

Radiomic Parameters for the Evaluation of Response to Treatment in Metastatic Colorectal Cancer Patients with Liver Metastasis: Findings from the CAVE-GOIM mCRC Phase 2 Trial

Authors: Erika Martinelli, Davide Ciardiello, Giulia Martini, Stefania Napolitano, Sara Del Tufo, Luca D’Ambrosio, Marco De Chiara, Vincenzo Famiglietti, Valeria Nacca, Claudia Cardone, Antonio Avallone, Chiara Cremolini, Filippo Pietrantonio, Evaristo Maiello, Vincenza Granata, Teresa Troiani, Salvatore Cappabianca, Fortunato Ciardiello, Valerio Nardone, Alfonso Reginelli

Published in: Clinical Drug Investigation

Login to get access

Abstract

Background

CAVE is a single arm, Phase 2 trial, that demonstrated anti-tumor activity of cetuximab rechallenge plus avelumab in patients with RAS wild type (wt) metastatic colorectal cancer (mCRC).

Objective

We conducted a post hoc analysis to identify potential radiomic biomarkers for patients with CRC liver metastasis (LM).

Patients and Methods

Patients with LM that could be measured by enhanced contrast phase computed tomography (CT) imaging at baseline and at first response evaluation were included. Multiple texture parameters were extracted with the LifeX Software. Delta-texture (D-TA) variations were calculated by comparing data at baseline and after treatment.

Results

Overall, 55/77 patients (71%) had LM; 39 met the inclusion criteria for the current analysis. The D-TA parameters that significantly correlated at univariate analysis with median progression-free survival (mPFS) were EntropyHistogram (p = 0.021), HomogeneityGLCM (p < 0.001) and Dissimilarity GLCM (p = 0.002). At multivariate analysis, only HomogeneityGLCM resulted significant for PFS (p = 0.001). Patients (19/39, 48.7%) with reduction of HomogeneityGLCM experienced better mPFS (4.6 vs 2.9 months; HR 0.45; 95% CI 0.23–0.88; p = 0.021) and median overall survival (mOS) (17.3 vs 6.8 months; HR 0.40, 95% CI 0.21–0.80; p = 0.010). A trend to better mPFS, was also observed in patients with RAS/BRAF wt circulating tumor DNA and reduction of HomogeneityGLCM. Overall survival was significantly better in this subgroup of patients with low HomogeneityGLCM: mOS was 17.8 (95% CI 15.5–20.2) versus 6.8 months (95% CI 3.6–10.0) (HR 0.34, 95% CI 0.14–0.81; p = 0.016).

Conclusion

Reduction in the D-TA parameter HomogeneityGLCM by radiomic analysis correlates with improved outcomes in patients with LM receiving cetuximab rechallenge plus avelumab therapy. Larger prospective studies are needed to validate and confirm these findings.
Appendix
Available only for authorised users
Literature
18.
go back to reference Bullock AJ, Fakih MG, Gordon MS, et al. Results from an expanded phase 1 trial of botensilimab, a multifunctional anti-CTLA-4, plus balstilimab (anti-PD-1) for metastatic heavily pretreated microsatellite stable colorectal cancer. Ann Oncol. 2023;34(suppl 1):S178–9.CrossRef Bullock AJ, Fakih MG, Gordon MS, et al. Results from an expanded phase 1 trial of botensilimab, a multifunctional anti-CTLA-4, plus balstilimab (anti-PD-1) for metastatic heavily pretreated microsatellite stable colorectal cancer. Ann Oncol. 2023;34(suppl 1):S178–9.CrossRef
20.
go back to reference Ravanelli M, Agazzi GM, Tononcelli E, et al. Texture features of colorectal liver metastases on pretreatment contrast-enhanced CT may predict response and prognosis in patients treated with bevacizumab-containing chemotherapy: a pilot study including comparison with standard chemotherapy. Radiol Med. 2019;124(9):877–86. https://doi.org/10.1007/s11547-019-01046-4.CrossRefPubMed Ravanelli M, Agazzi GM, Tononcelli E, et al. Texture features of colorectal liver metastases on pretreatment contrast-enhanced CT may predict response and prognosis in patients treated with bevacizumab-containing chemotherapy: a pilot study including comparison with standard chemotherapy. Radiol Med. 2019;124(9):877–86. https://​doi.​org/​10.​1007/​s11547-019-01046-4.CrossRefPubMed
Metadata
Title
Radiomic Parameters for the Evaluation of Response to Treatment in Metastatic Colorectal Cancer Patients with Liver Metastasis: Findings from the CAVE-GOIM mCRC Phase 2 Trial
Authors
Erika Martinelli
Davide Ciardiello
Giulia Martini
Stefania Napolitano
Sara Del Tufo
Luca D’Ambrosio
Marco De Chiara
Vincenzo Famiglietti
Valeria Nacca
Claudia Cardone
Antonio Avallone
Chiara Cremolini
Filippo Pietrantonio
Evaristo Maiello
Vincenza Granata
Teresa Troiani
Salvatore Cappabianca
Fortunato Ciardiello
Valerio Nardone
Alfonso Reginelli
Publication date
17-06-2024
Publisher
Springer International Publishing
Published in
Clinical Drug Investigation
Print ISSN: 1173-2563
Electronic ISSN: 1179-1918
DOI
https://doi.org/10.1007/s40261-024-01372-0