Signal enhancement ratio of CE-MRI: a potential biomarker of survival after hepatic arterial infusion chemotherapy in biliary tract cancers

Abstract

Background The association of contrast-enhanced MRI (CE-MRI) and the overall survival (OS) of biliary tract cancers (BTC) is ambiguous. Thus, the aim of this study is to evaluate the value of signal enhancement ratio (SER) and its early change in CE-MRI as biomarkers of survival after hepatic arterial infusion chemotherapy (HAIC) in BTC. Results One hundred and two BTC patients treated via HAIC with 3cir-OFF regimen between January 2011 and June 2020 were enrolled in this retrospective study. The median progression-free survival (PFS) and OS were 9.8 months [range 1.5–83.3 months, 95% confidence interval (CI) 7.789–11.811] and 14.2 months (range 1.8–83.3 months, 95% CI: 11.106–17.294), respectively. The cutoff value of SER before HAIC (SER0) was 1.04, and both median PFS and OS in the SER0 ≥ 1.04 group were longer than in the SER0 < 1.04 group (median PFS: 10.5 vs. 8.5 months, p = 0.027; median OS: 23.9 vs. 12.3 months, p < 0.001). The median OS in the ΔSER > 0 group was longer than in the ΔSER < 0 group (17.3 versus 12.8 months, p = 0.029 (ΔSER means the change of SER after two cycles of HAIC). Multivariate analysis showed SER0 (p = 0.029) and HAIC treatment cycle (p = 0.002) were independent predictors of longer survival. Conclusions SER in CE-MRI before HAIC (SER0) is a potential biomarker for the prediction of survival after HAIC in advanced BTC.

Case report: Preliminary response to tislelizumab plus S-1 in patients with metastatic gallbladder carcinoma: A report of five cases and a literature review

“…Another report showed that pembrolizumab monotherapy in BTC patients with PD-L1 expression in 1% or more of tumor cells or with tumor-infiltrating lymphocytes achieved responses in 4 out of 24 (17%) patients ( 19 ). Hepatic artery infusion chemotherapy (HAIC) in combination with immunotherapy also has high anti-tumor activity ( 20 – 22 ). One retrospective study pooled over 100 BTC patients treated via HAIC with the 3cir-OFF regimen, which is comprised of oxaliplatin, 5-fluorouracil, and folinic acid.…”

“…One retrospective study pooled over 100 BTC patients treated via HAIC with the 3cir-OFF regimen, which is comprised of oxaliplatin, 5-fluorouracil, and folinic acid. The median PFS and OS of patients receiving this regimen were 9.8 months and 14.2 months, respectively ( 22 ). A study from China showed that tislelizumab was also observed to have anti-tumor activities in other solid tumors with an ORR ≥15% including nasopharyngeal carcinoma (43%), MSI-H/deficient mismatch repair (dMMR) solid tumors (19%), non-small cell lung cancer (18%), gastric cancer (17%), hepatocellular carcinoma (17%), and melanoma (15%) ( 23 ).…”