Dynamic contrast-enhanced magnetic resonance imaging biomarkers predict survival and response in hepatocellular carcinoma patients treated with sorafenib and metronomic tegafur/uracil

Hsu, Chien‐Tien; Shen, Ying‐Chun; Yu, Chih‐Wei; Hsu, Chiun; Hu, Fu‐Chang; Hsu, Chih‐Hung; Chen, Bang-Bin; Wei, Shih-Chung; Cheng, Ann‐Lii; Shih, Tiffany Ting-Fang

doi:10.1016/j.jhep.2011.01.032

Cited by 114 publications

(107 citation statements)

References 37 publications

Supporting

Mentioning

103

Contrasting

Order By: Relevance

“…Modifications during sorafenib treatment can be assessed also using perfusion-imaging techniques. Hsu et al [109] found good correlations between K trans values and survival in patients who received sorafenib plus metronomic tegafur/uracil therapy: baseline K trans was higher in patients with RECIST partial response (PR) or stable disease (SD) than in those with progressive disease (PD). Frampas et al [110] reported a non-significant decrease in all pCT-derived values between RECIST non-progressors and progressors treated with sorafenib.…”

Section: Primary Liver Tumorsmentioning

confidence: 99%

“…Hsu et al [109] 31 DCE-MRI Ktrans decrease HCC sorafenib+metronomic tegafur/uracil Yopp et al [111] 17 DCE-MRI AUC90/AUC180/K trans decrease HCC bevacizumab Jiang et al [112] 23 pCT BF/BV/PS decrease HCC bevacizumab + cytotoxic agents MTT increase Kim et al [113] 10 DCE-MRI/DWI K trans /Kep decrease HCC sunitinib ADC increase Sahani et al [114] 23 DCE-MRI/DWI K trans /Kep decrease HCC sunitinib ADC increase Kim et al [123] 35 pCT BF decrease CRC metastases XELOX, FOLFOX, FOLFIRI Schlemmer et al [124] 24…”

Section: Primary Liver Tumorsmentioning

confidence: 99%

See 1 more Smart Citation

Prognostication and response assessment in liver and pancreatic tumors: The new imaging

Robertis¹,

Martini²,

Demozzi³

et al. 2015

WJG

View full text Add to dashboard Cite

Diffusion-weighted imaging (DWI), dynamic contrastenhanced magnetic resonance imaging (DCE-MRI) and perfusion computed tomography (CT) are technical improvements of morphologic imaging that can evaluate functional properties of hepato-bilio-pancreatic tumors during conventional MRI or CT examinations. Nevertheless, the term "functional imaging" is commonly used to describe molecular imaging techniques, as positron emission tomography (PET) CT/MRI, which still represent the most widely used methods for the evaluation of functional properties of solid neoplasms; unlike PET or single photon emission computed tomography, functional imaging techniques applied to conventional MRI/CT examinations do not require the administration of radiolabeled drugs or specific equipments. Moreover, DWI and DCE-MRI can be performed during the same session, thus providing a comprehensive "one-step" morphological and functional evaluation of hepato-bilio-pancreatic tumors. Literature data reveal that functional imaging techniques could be proposed for the evaluation of these tumors before treatment, given that they may improve staging and predict prognosis or clinical outcome. Microscopic changes within neoplastic tissues induced by treatments can be detected and quantified with functional imaging, therefore these techniques could be used also for posttreatment assessment, even at an early stage. or altered cellular membranes will present diffusion restriction, which is depicted as signal hyperintensity areas on high b-value DW images and hypointensity on the apparent diffusion coefficient (ADC) maps; ADC measurement can also quantify water molecules' diffusion. As dedifferentiation or therapies may induce microscopic changes in neoplastic tissues that could modify water molecules' diffusion, DWI can distinguish between different degrees of malignancy and can be also proposed for post-treatment monitoring. Moreover, DWI can be performed in a single session with DCE-MRI, thus providing a comprehensive "one-step" morphological and functional evaluation of hepatobilio-pancreatic tumors.Perfusion imaging techniques evaluate changes in signal intensity (DCE-MRI) or density (pCT) after contrast medium injection, being therefore able to assess microvascularization through the evaluation of the dynamics of contrast medium distribution from vessels to the neoplastic tissue. Perfusion parameters are therefore theoretically good candidates for the evaluation of microscopic vascular differences between lesions with different pathological grade and for the assessment of treatment response, especially after chemoembolization or during treatments with antiangiogenic drugs.This editorial analyzes up-to-date literature data regarding the application of functional imaging techniques, apart from molecular imaging, to hepatic and pancreatic tumors, with particular emphasis on correlations to pathological features, prognostic stratification and therapeutic response assessment. FUNCTIONAL IMAGING TECHNIQUES: TECHNICAL BASESIn 1965 Stejskal and Tanne...

show abstract

Section: Primary Liver Tumorsmentioning

confidence: 99%

Section: Primary Liver Tumorsmentioning

confidence: 99%

Prognostication and response assessment in liver and pancreatic tumors: The new imaging

Robertis¹,

Martini²,

Demozzi³

et al. 2015

WJG

View full text Add to dashboard Cite

show abstract

“…In one study of locally advanced HCCs receiving bevacizumab and cytotoxic therapy, high pretreatment K trans indicated which patients had a RECIST response (37). In another study, high pretreatment K trans indicated those patients with HCCs who did not develop progressive disease on sunitinib and cytotoxic therapy (38). However, pretreatment K trans did not relate to PFS or OS in either study.…”

Section: Locally Advanced Hcc and Other Solid Tumorsmentioning

confidence: 99%

“…However, pretreatment K trans did not relate to PFS or OS in either study. Four studies have shown that, similar to mRCCs, acute pharmacodynamic changes in K trans or similar parameters relate to delayed clinical progression in HCCs (38)(39)(40)(41). Another has shown that the modified Choi criteria discriminated between shorter or longer PFS intervals, but unlike mRCC data, no relationship was seen with OS (42).…”

Section: Locally Advanced Hcc and Other Solid Tumorsmentioning

confidence: 99%

Do Imaging Biomarkers Relate to Outcome in Patients Treated with VEGF Inhibitors?

O’Connor

Jayson

2012

Clinical Cancer Research

View full text Add to dashboard Cite

The management of solid tumors has been transformed by the advent of VEGF pathway inhibitors. Early clinical evaluation of these drugs has used pharmacodynamic biomarkers derived from advanced imaging such as dynamic MRI, computed tomography (CT), and ultrasound to establish proof of principle. We have reviewed published studies that used these imaging techniques to determine whether the same biomarkers relate to survival in renal, hepatocellular, and brain tumors in patients treated with VEGF inhibitors. Data show that in renal cancer, pretreatment measurements of K trans and early pharmacodynamic reduction in tumor enhancement and density have prognostic significance in patients treated with VEGF inhibitors. A weaker, but significant, relationship is seen with subtle early size change (10% in one dimension) and survival. Data from high-grade glioma suggest that pretreatment fractional blood volume and K trans were prognostic of overall survival. However, lack of control data with other therapies prevents assessment of the predictive nature of these biomarkers, and such studies are urgently required.

show abstract

“…Hahn et al (6) found that the area under the contrast concentration vs. time curve 90 s after contrast injection (IAUC90) and the volume transfer constant of contrast agent (Ktrans) are pharmacodynamic biomarkers for sorafenib. Hsu et al (7) also found that, among the prognostic factors of HCC patients receiving sorafenib and tegafur/uracil treatment, Ktrans was closely correlated with tumor response. In an experimental prostate cancer study in mice, sorafenib significantly suppressed tumor perfusion, vascular growth, and CT-visible endothelial permeability region (5).…”

Section: Introductionmentioning

confidence: 95%

Arterial blood supply of hepatocellular carcinoma is associated with efficacy of sorafenib therapy

Zhang¹,

Zhu²,

Li³

et al. 2015

Hepatoma Res

View full text Add to dashboard Cite

Results: Among these 38 patients [35 (92.1%) were males] treated with sorafenib, the median age was (53.3±11.1) years. Tumors in 17 patients had good arterial supply while those in the remained 21 patients had poor arterial supply. The median survival time (MST) was 10.7 months (95% CI, 8.7-12.7) and the 1-year overall survival (OS) was 41.0%. The MST and 1-year OS in patients with tumors with good arterial supply were 12 months (range, 4-20 months) and 52.9%, respectively, compared with those of 7 months (range, 1-16 months) and 23.8% in patients with tumors with poor arterial supply (P=0.002). Patients with BCLC stage B tumors had longer MST and higher OS than those with BCLC stage C tumors, although the differences were not statistically significant.Multivariate analysis showed that arterial supply of tumors remained statistically predictive for OS (HR =0.22; 95% CI, 0.07-0.67; P=0.008).Conclusions: Arterial blood supply is an independent predictor for survival in HCC patients treated with sorafenib, and patients with tumors with good arterial supply benefit more than those with tumors with poor arterial supply.Keywords: Hepatocellular carcinoma (HCC); sorafenib; arterial blood supply Submitted Dec 05, 2014. Accepted for publication Dec 05, 2014Dec 05, . doi: 10.3978/j.issn.2305Dec 05, -5839.2015 View this article at: http://dx.doi.org/10.3978/j.issn. 2305-5839.2015.10.24 Introduction Hepatocellular carcinoma (HCC) is a clinically common disease. As the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections increases worldwide, the incidence of HCC also gradually rise. HCC is now the third leading cause of cancer deaths (1). Only about 15% of HCC have a chance to be cured by surgery (e.g., liver resection or transplantation) or minimally invasive local treatment (e.g., radiofrequency ablation). For HCC at advanced stages, radical treatment is impossible and multidisciplinary treatment may be more feasible (2).As a multiple kinase inhibitor, sorafenib can selectively inhibit the vascular endothelial growth factor 2/plateletderived growth factor receptor pathway to prevent tumor angiogenesis and meanwhile suppress cell proliferation by targeting the mitogen-activated protein kinase signaling pathway. Two global phase III clinical trials [SHARP (3) and Asia-Pacific trial (4)] have demonstrated that sorafenib can improve the prognosis of patients with advanced HCC. Among studies focusing on the prognostic factors of HCC patients treated with sorafenib, many of them found that the prognosis of these patients may be associated with the computed tomography (CT) and magnetic resonance imaging (MRI) features (5-10). Hahn et al. (6) found that the area under the contrast concentration vs. time curve 90 s after contrast injection (IAUC90) and the volume transfer constant of contrast agent (Ktrans) are pharmacodynamic biomarkers for sorafenib. Hsu et al. (7) also found that, among the prognostic factors of HCC patients receiving sorafenib and tegafur/uracil treatment, Ktrans was closely cor...

show abstract

Dynamic contrast-enhanced magnetic resonance imaging biomarkers predict survival and response in hepatocellular carcinoma patients treated with sorafenib and metronomic tegafur/uracil

Cited by 114 publications

References 37 publications

Prognostication and response assessment in liver and pancreatic tumors: The new imaging

Prognostication and response assessment in liver and pancreatic tumors: The new imaging

Do Imaging Biomarkers Relate to Outcome in Patients Treated with VEGF Inhibitors?

Arterial blood supply of hepatocellular carcinoma is associated with efficacy of sorafenib therapy

Contact Info

Product

Resources

About